摘要
【目的】探讨MRI信号改变与高胆红素血症的严重程度的相关性，为胆红素脑病的早期诊断提供客观依据。【方法】432例重度高胆红素血症新生儿[血清总胆红素（TSB）≥342μmol／L）]在黄疸高峰期后接受头部MRI检查，根据TSB峰值将高胆红素血症患儿分为轻度组（342～427．5μmol／L），中度组（427．5～513μmol／L）和重度组（≥513μmol／L），分析MRI T1WI苍白球高信号阳性率与TSB水平的关系，并进行统计学分析。【结果】432例重度高胆红素血症患儿中338例苍白球T1WI呈对称性高信号改变（78．2％），重度组阳性率最高（94．4％，34／36），中度组和轻度组阳性率分别为80．5％（95／118），75．2％（209／278），黄疸程度与苍白球信号改变有密切关系（X2=7．438，P=0．024）；早期新生儿组苍白球信号改变（82．5％，222／269）明显高于晚期新生儿组（71．2%，116／163），差异有统计学意义（X2=7．697，P〈0．01）。【结论】MRI T1WI苍白球对称性高信号与高胆红素血症的严重程度及日龄密切相关，是新生儿急性胆红素脑病的重要表现特征。
[ObjectivelTo explore the correlation between the change of MRI signal and the severity of hyperbilirubinemia so as to p.rovide the basis for early diagnosis of bilirubin encephalopathy. [Methods] Totally 432 neonates with severe hyperbilirubinemia[TSB（total serum bilirubin）≥342μmol/L] received cerebral MRI examination after the peak jaundice. According to the peak of serum bilirubin, pediatric patients with hyperbilirubinemia were divided into three groups（342 μmol/L≤TSB 〈 427.5 μmol/L, 427.5 μmol/L≤ TSB 〈 513μmol/L and TSB≥513μmol/L, respectively）. The relationship between the positive rate of high signal of globus pallidus on T1WI of MRI and TSB was analyzed by statistics. [Results] Among 432 pediatric patients with severe hyperbilirubinemia, 338 pediatric patients（78.2%） had symmetric change of high signal of globus pallidus on T1WI. The positive rate in the group with TSB≥513 μmol/L was the highest（94.%, 34/36）. The positive rate in the groups with 427. 5~513 btmol/L and 342-427. 5μmol/L were 80. 5% （95/118） and 75.2% （209/278）, respectively. The degree of jaundice was closely related with the signal change of globus pallidus（X2 =7. 438, P =0. 024）. The signal change of globus pallidus in early neonate group（82.5%, 222/ 269） was obviously higher than that in late neonate group（71.2%, 116/]63）, and there was significant difference（X2=7. 697, P 〈0.01）. [Conclusion] Symmetric high globus pallidus signal on T1WI of MRI is closely related with the severity of hyperbilirubinemia and age days, and may be important characteristics of acute bilirubin encephalopathy in neonates.
出处
《医学临床研究》
CAS
2013年第10期1973-1975,共3页
Journal of Clinical Research
关键词
核黄疸
胆红素
血液
磁共振成像
Kernicterus
Bilirubin/BL
Magnetic Resonance Imaging
