新生儿胆红素脑病磁共振成像及波谱诊断价值研究  

Values of magnetic resonance imaging and spectrum in neonatal bilirubin encephalopathy

作　　者：严宗伟[1] 曾燕妮 Yan Zongwei;Zeng Yanni(Department of Radiology,Huadu District People's Hospital of Guangzhou,Guangzhou 510800,China)

机构地区：[1]广州市花都区人民医院放射科,广州510800

出　　处：《国际医药卫生导报》2022年第22期3180-3185,共6页International Medicine and Health Guidance News

摘　　要：目的探讨新生儿胆红素脑病的磁共振成像(MRI)和氢质子波谱特征以及其临床诊断价值。方法收集2016年1月至2020年4月广州市花都区人民医院22例新生儿胆红素脑病患儿,对照组为正常足月新生儿共20例,分别进行常规MRI扫描和双侧苍白球氢质子磁共振波谱(1H-MRS)分析。由2位放射科副主任医生阅片,评价两组新生儿的常规MRI图像特征。采用PRESS脉冲序列获得双侧苍白球的1H-MRS数据,对两组新生儿乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱(Cho)、NAA/Cr、NAA/Cho、Cho/Cr等值进行统计学分析,42例新生儿的MRS各项数值NAA、Cr、Cho、NAA/Cr、Cho/Cr、NAA/Cho比值与血清总胆红素(TSB)峰值分别进行双变量相关性分析。采用F检验、独立样本t检验、Pearson相关性分析。结果胆红素脑病组日龄(7.4±2.6)d,胎龄(37.89±2.1)周;对照组日龄(9.2±4.8)d,胎龄(38.6±1.9)周。22例胆红素脑病患儿中,18例(81.8%)在双侧苍白球中出现T1加权成像(T1WI)图像异常高信号,12例(54.5%)相应部位T2加权成像液体衰减反转恢复序列(T2WIFLAIR)信号轻度增高。胆红素脑病组双侧苍白球MRS与对照组相比,NAA、NAA/Cho、NAA/Cr比值显著降低,两组间差异均有统计学意义(均P<0.05)。结论MRI结合1H-MRS是新生儿胆红素脑病的重要辅助诊断方法。Objective To investigate the characteristics and clinical diagnostic values of magnetic resonance imaging(MRI)and proton magnetic resonance spectrum(1H-MRS)in neonatal bilirubin encephalopathy.Methods Twenty-two neonates with bilirubin encephalopathy in Huadu District People's Hospital of Guangzhou from January 2016 to April 2020 were selected,and twenty normal full-term newborns were selected as control.Conventional MRI scan and 1H-MRS of the bilateral globus pallidus were performed separately.Two associate chief doctors of the radiology evaluated the conventional MRI features.The 1H-MRS data of the bilateral globus pallidus were obtained by PRESS sequence,and the values of N-aceytl aspartate(NAA),creatine(Cr),choline(Cho),NAA/Cr,NAA/Cho,and Cho/Cr were statistically analyzed between the two groups.Bivariate correlation analysis was conducted for the values of NAA,Cr,Cho,NAA/Cr,Cho/Cr,and NAA/Cho and total serum bilirubin(TSB)peak value among the 42 neonates.F-test,independent sample t-test,and Pearson correlation analysis were used.Results The age of the bilirubin encephalopathy group was(7.4±2.6)days,and the gestational age was(37.89±2.1)weeks;the age of the control group was(9.2±4.8)days,and the gestational age was(38.6±1.9)weeks.In the bilirubin encephalopathy group,18 cases(81.8%)had an abnormally high signal of T1 weighted imaging(T1WI)images in the bilateral globus pallidus and 12 cases(54.5%)had slightly increased signal in corresponding position in T2WI fluid attenuated inversion recovery(FLAIR)sequence.The values of NAA,NAA/Cho,and NAA/Cr of the bilateral globus pallidus MRS in the bilirubin encephalopathy group were significantly reduced compared with those in the control group,with statistically significant differences between two groups(all P<0.05).Conclusion MRI combined with 1H-MRS is an important auxiliary diagnostic method for neonatal bilirubin encephalopathy.

关 键 词：胆红素脑病 MRI 磁共振波谱 新生儿 

分 类 号：R722.1[医药卫生—儿科]