摘要
目的:分析新生儿高胆红素血症脑损伤的MRI影像学表现。初步探讨苍白球MRI信号强度量化对于新生儿高胆红素血症脑损伤的诊断价值。方法:收集2018年1月—2023年5月我院临床诊断为新生儿高胆红素血症患儿30例(其中诊断为急性胆红素脑病6例)和健康新生儿15例,胆红素诱导的神经功能障碍量表评分用于确定参与者是否患有急性胆红素脑病。所有新生儿行头颅常规MRI扫描,在T_(1)WI图像上测量苍白球的相对信号强度。采用受试者工作特征曲线分析评价3项指标的诊断价值。结果:高胆红素血症新生儿苍白球相对信号强度与血清总胆红素水平有显著相关性(r=0.821,P<0.001)。TSB重度增高组苍白球相对信号强度显著高于TSB中度增高组、TSB轻度增高组和健康观察组。急性胆红素脑病组苍白球相对信号强度显著高于非急性胆红素脑病组(P<0.01)。苍白球相对信号强度的ROC曲线下面积为0.759(P<0.01),敏感性为0.667,特异性为0.750。血清总胆红素曲线下面积为0.618,传统目测苍白球信号曲线下面积为0.563。相对信号强度曲线下面积显著大于血清总胆红素和传统阅片(P<0.05)。结论:苍白球相对信号强度是一种客观的评价指标,有望成为新生儿高胆红素血症脑损伤的诊断工具。
Objective:To analyze the MRI imaging manifestations of neonatal hyperbilirubinemic brain injury.To preliminarily investigate the diagnostic value of quantification of pallid globe MRI signal intensity for neonatal hyperbilirubinemic brain injury.Methods:30 cases of children clinically diagnosed with neonatal hyperbilirubinemia(including 6 cases diagnosed with acute bilirubin encephalopathy)and 15 cases of healthy newborns were collected from January 2018 to May 2023 at our hospital.The Bilirubin-Induced Neurological Dysfunction Scale score was used to determine whether participants had acute bilirubin encephalopathy.All newborns underwent routine MRI scanning of the skull,and the relative signal intensity of the pallidum was measured on T_(1)WI images.The diagnostic value of the 3 indices was evaluated using subject work characteristic curve analysis.Results:There was a significant correlation between the relative signal intensity of the pale globules and serum total bilirubin levels in neonates with hyperbilirubinemia(r=0.821,P<0.001).The relative signal intensity of the pale globules in the group with severely elevated TSB was significantly higher than that in the group with moderately elevated TSB,in the group with mildly elevated TSB,and in the healthy observation group.The relative signal intensity of the pale globule was significantly higher in the acute bilirubin encephalopathy group than in the non-acute bilirubin encephalopathy group(P<0.01).The area under the receiver operating characteristic curve for relative signal intensity of pale globules was 0.759(P<0.01),with a sensitivity of 0.667 and a specificity of 0.750.The area under the curve for serum total bilirubin was 0.618,and the area under the curve for conventional visualization of pale globules was 0.563.The area under the curve for relative signal intensity was significantly greater than that of serum total bilirubin and conventional radiography(P<0.05).Conclusion:Relative signal intensity of the albumin globule is an objective evaluation index and promises to be a diagnostic tool for neonatal hyperbilirubinemic brain injury.
作者
朱志韬
金怀玉
刘婕
杨杰
石国富
ZHU Zhitao;JIN Huaiyu;LIU Jie(The Second People’s Hospital of Lianyungang(Lianyungang Second People’s Hospital Affiliated to Kangda College of Nanjing Medical University,the Oncology Hospital of Lianyungang),Lianyungang City,Jiangsu Province 222023)
出处
《医学理论与实践》
2024年第4期545-548,544,共5页
The Journal of Medical Theory and Practice
基金
连云港市第二人民医院中青年医学人才成长基金(TQ201904)。
