摘要
目的:分析新生儿胆红素脑病的1H-MRS特征及MRI特点,探讨MRI及1H-MRS的诊断价值,同时随访其临床转归,为临床提供可靠依据。方法:搜集2015年1月-2022年11月中山市博爱医院43例胆红素脑病患儿,所有患儿均行头颅MRI及磁共振波谱成像(magnetic resonance spectrum,MRS)检查。由两位高年资诊断医生评估三组病例MRI图像特征,将波谱成像数据导入工作站进行分析处理,对乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱(Cho)、NAA/Cr、NAA/Cho、Cho/Cr等值进行统计学分析,之后同血清总胆红素(TSB)峰值分别进行双变量相关性分析。结果:胆红素脑病患儿中,39例(90.7%)在双侧苍白球T_(1)WI图像出现异常高信号,25例(58.1%)相同位置T_(2)WI-FLAIR图像信号轻度增高。43例患儿MRS各项代谢物数值分别为:NAA为(0.011±0.003)、Cr为(0.013±0.002)、Cho为(0.022±0.003)、NAA/Cho为(0.561±0.144)、NAA/Cr为(0.846±0.272)、Cho/Cr为(1.692±0.283)。经K-S拟合优度检验,胆红素脑病患儿TSB峰值及NAA、NAA/Cr、NAA/Cho值均符合正态分布,采用Pearson相关性分析分别对NAA、NAA/Cr、NAA/Cho与TSB峰值分别进行相关性检验,结果显示,NAA、NAA/Cr、NAA/Cho与TSB峰值有显著相关性(P<0.05)。随访患儿发生听觉障碍、运动障碍、智力低下等情况占比达39.53%。结论:MRI苍白球T_(1)WI对称性高信号对于诊断新生儿胆红素脑病具有一定的特征性,MRS对新生儿胆红素脑病的诊断有一定帮助,值得临床应用推广。
Objective To analyze the 1H-MRS and MRI features of neonatal bilirubinemia and bilirubin encephalopathy,to explore the diagnostic value of MRI and 1H-MRS,and to follow up their clinical outcomes so as to provide reliable basis for clinic.Methods A total of 43 children with bilirubin encephalopathy in Zhongshan Boai Hospital from January 2015 to November 2022 were collected.All children were examined by MRI and magnetic resonance spectrum(MRS).The MRI image characteristics of the three groups were evaluated by two senior diagnostic doctors,and the spectral imaging data were imported into the workstation for analysis and processing.The values of N-acetylaspartic acid(NAA),creatine(Cr),choline(Cho),NAA/Cr,NAA/Cho and Cho/Cr were statistically analyzed,and then bivariate correlation analysis was carried out with the peak value of serum total bilirubin(TSB).Results Among the children with bilirubin encephalopathy,39 cases(90.7%)showed abnormal high signal intensity in bilateral globus pallidus T_(1)WI images,and 25 cases(58.1%)showed slight increase in T_(2)WI-FLAIR images at the same position.The metabolite values of MRS in 43 children were as follows:NAA(0.011±0.003),Cr(0.013±0.002),Cho(0.022±0.003),NAA/Cho(0.561±0.144),NAA/Cr(0.846±0.272),Cho/Cr(1.692±0.283).The peak value of TSB and the ratio of NAA,NAA/Cr and NAA/Cho in children with bilirubin encephalopathy conformed to normal distribution by the Kolmogorov-Smirnov(K-S)test for goodness-of-fit test.Pearson correlation analysis was used to test the correlation between the peak value of NAA,NAA/Cr,NAA/Cho and TSB,respectively.The results showed that there was a significant correlation between NAA,NAA/Cr,NAA/Cho and the peak value of TSB(P<0.05).During the follow-up,hearing impairment,motor impairment and mental retardation accounted for 39.53%.Conclusion The symmetrical high signal intensity of MRI globus pallidus T_(1)WI has certain characteristics in the diagnosis of neonatal bilirubin encephalopathy.MRS is helpful in the diagnosis of neonatal bilirubin en
作者
卿时军
罗师
孙多成
廖敬波
夏雨
QING Shijun;LUO Shi;SUN Duocheng;LIAO Jingbo;XIA Yu(Department of Medical Imaging,Boai Hospital of Zhongshan,Zhongshan,Guangdong 528403,China)
出处
《影像研究与医学应用》
2023年第12期4-6,10,共4页
Journal of Imaging Research and Medical Applications
