3.0 T MAGIC弛豫时间定量技术在新生儿急性胆红素脑病中的应用价值  

Application value of 3.0 T MAGIC relaxation time quantitative technique in neonates with acute bilirubin encephalopathy

作　　者：李艳[1] 张小羽[1] 刘岭岭[1] 李鹏[1] 刘世莉 陈志强[1,2] 张社宁 邱银萍[3] 杨萍[3] LI Yan;ZHANG Xiaoyu;LIU Lingling;LI Peng;LIU Shili;CHEN Zhiqiang;Zhang Shening;QIU Yinping;YANG Ping(Department of Radiology,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Radiology,the First Affiliated Hospital of Hainan Medical College,Haikou 570100,China;Department of Neonatology,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院放射科,银川750004 [2]海南医学院第一附属医院放射科,海口570100 [3]宁夏医科大学总医院新生儿科,银川750004

出　　处：《磁共振成像》2023年第10期65-70,97,共7页Chinese Journal of Magnetic Resonance Imaging

基　　金：宁夏回族自治区重点研发计划项目(编号:2019BEG03033);宁夏回族自治区自然科学基金(编号:2022AAC03472);宁夏医科大学校级课题(编号:XM2021071)。

摘　　要：目的探讨MAGIC弛豫时间定量技术评估新生儿急性胆红素脑病(acute bilirubin encephalopathy,ABE)的价值。材料与方法前瞻性纳入2020年10月至2022年6月在宁夏医科大学总医院PICU因黄疸入院确诊的ABE患儿32例(ABE组),高胆红素血症患儿71例(高胆组),同期44例正常足月儿(对照组)作为研究对象,所有被纳入研究对象均于出生后10 d内在我院完成头颅磁共振MAGIC检查,并测量双侧苍白球、壳核、丘脑腹外侧核、内囊后肢、内囊前肢、大脑脚6个感兴趣区(region of interest,ROI)的弛豫值(TI、T2)及质子密度(proton density,PD)值;采用单因素方差分析比较各组间T1、T2、PD值;采用受试者工作特征(receiver operating characteristic,ROC)曲线分析各定量参数诊断ABE的曲线下面积(area under the curve,AUC)、最佳临界值、敏感度、特异度、约登指数;采用Pearson相关分析ROI的T1、T2、PD值与血清胆红素(total serum bilirubin,TSB)的相关性。结果苍白球T1、T2值在三组间差异有统计学意义(P<0.05),在ABE组最低,高胆组次之,对照组最高。内囊后肢T1、T2值及大脑脚T1值在三组间差异有统计学意义(P<0.05),ABE组最高,高胆组次之,对照组最低。T1值中苍白球AUC(0.977)最高且敏感度(95.3%)、特异度(92.0%)也最高,内囊后肢、大脑脚次之;而T2值中苍白球AUC(0.880)、内囊后肢AUC(0.857)相近,苍白球特异度略高(82.1%),内囊后肢敏感度略高(79.1%)。苍白球T1值与TSB呈负相关(r=-0.541,P<0.05),内囊后肢、大脑脚T1值与TSB呈正相关(r=0.503、0.384,P均<0.05)。结论MAGIC弛豫时间定量技术在诊断新生儿ABE具有较高的临床价值,测量苍白球、内囊后肢T1、T2值及大脑脚T1值能够为临床早期诊断新生儿ABE提供客观、定量影像学参考依据。Objective:To investigate the application value of MAGIC relaxation time quantitative technique in the evaluation of acute bilirubin encephalopathy(ABE).Materials and Methods:Thirty-two children with confirmed ABE(ABE group)admitted to the PICU of Ningxia Medical University for jaundice from October 2020 to June 2022,71 children with hyperbilirubinemia(hyperbilirubinemia group),and 44 normal-term children(control group)as the study subjects.All the included subjects completed cranial MAGIC examination in our hospital within 10 days after birth,and measured the relaxation value T1,T2 andproton density(PD)values in 6 areas of interest(ROI),including bilateral glous pallidus,putamen,ventrolateral thalamic nucleus,posterior limb of internal capsule,anterior limb of internal capsule,pedunculus cerebri.The values of T1,T2 and PD among all groups were compared by one-way variance analysis;the area under the curve(AUC),optimal critical value,sensitivity,specificity and Yoden index of ABE were analyzed by receiver operating characteristic(ROC)curve;Pearson correlation was used to analyze the correlation between T1,T2,PD and total serum bilirubin(TSB)in each area of interest.Results:The values of T1 and T2 in the globus pallidus were statistically significant among the three groups(P<0.05),which were the lowest in ABE,followed by the high bile group,and the highest in the control group.The T1 and T2 values of the posterior limb of the internal capsule and the T1 values of the pedunculus cerebral were statistically different among the three groups(P<0.05),with the highest value in the ABE group,followed by the high bile group,and the lowest in the control group.In T1,the pallidum AUC(0.977)had the highest sensitivity(95.3%),specificity(92.0%),the posterior limb and the cerebral foot;in T2,the pallidum AUC(0.880),the posterior capsule AUC(0.857),the slightly higher pallidum specificity(82.1%),and the internal capsule(79.1%).T1 values of the globus pallidus were negatively correlated with TSB(r=-0.541,P<0.05),and T1 values of

关 键 词：新生儿 高胆红素血症 胆红素脑病 集成磁共振成像 磁共振成像 苍白球 

分 类 号：R445.2[医药卫生—影像医学与核医学] R722.17[医药卫生—诊断学] R742[医药卫生—临床医学]