文章摘要
田兆方,柏根基,赵 赛,程怀平,杨丽娟.常规磁共振及氢质子磁共振频谱在新生儿高胆红素血症中临床应用[J].南京医科大学学报,2010,(12):1752~1755
常规磁共振及氢质子磁共振频谱在新生儿高胆红素血症中临床应用
The value of conventional MRI and 1H-MRS in early diagnosis of brain damage in neonatal hyperbilirubinemia
  
DOI:10.7655
中文关键词: 磁共振成像  磁共振波谱学  黄疸  新生儿
英文关键词: magnetic resonance imaging  proton MR spectroscopy  hyperbilirubinemia  neonate
基金项目:
作者单位
田兆方 南京医科大学附属淮安第一医院新生儿科,1影像科,江苏 淮安 223300 
柏根基 南京医科大学附属淮安第一医院新生儿科,1影像科,江苏 淮安 223300 
赵 赛 南京医科大学附属淮安第一医院新生儿科,1影像科,江苏 淮安 223300 
程怀平 南京医科大学附属淮安第一医院新生儿科,1影像科,江苏 淮安 223300 
杨丽娟 南京医科大学附属淮安第一医院新生儿科,1影像科,江苏 淮安 223300 
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中文摘要:
      目的: 探讨高胆红素血症新生儿磁共振(MRI)特征及脑内代谢物含量变化情况及与常规诊断指标的相关性?方法:对36例临床高血清胆红素水平(>290 ?滋mol/L)的患儿行常规磁共振T1WI?T2WI?DWI检查及氢质子磁共振频谱(proton magnetic resonance spectroscopy,1H-MRS)检测乙酰天门冬氨酸(NAA)?肌酸(Cr)?胆碱(Cho)的相对半定量浓度和NAA/Cr?Cho/Cr值,同时与常用的脑损伤指标如血清S100B水平?新生儿神经行为评定(neonatal behaviral neurological assessment,NBNA)进行比较,探讨MRI及1H-MRS对胆红素脑病早期诊断的价值?结果:12例苍白球为T1WI上对称性高信号,T2WI及DWI相上未见明显异常信号,MRI异常组NAA/Cr及Cho/Cr明显下降(P均<0.05),Cho/NAA改变不明显(P > 0.05);依据单项指标诊断脑损伤发生率分别为:临床22.2%,MRI 33.3%,MRS41.7%,NBNA 38.9%,S100B 36.11%?结论:采用1H-MRS及MRI检查能早期发现高胆红素血症导致的脑损伤,为临床的早期干预提供可靠的证据?
英文摘要:
      Objective: To investigate the characteristics of magnetic resonance imaging(MRI) in brain,and changes in brain metabolites proton MR Spectroscopy(1H-MRS) of neonate with hyperbilirubinemia,and the relationship between those changes and common diagnostic parameters of brain injury. Methods: Thirty-six children with neonatal hyperbilirubinemia(serum bilirubin >290 ?滋mol/L)were inspected by MRI and MRS,serum SB100B were also detected,and neonatal behaviral neurological assessment(NBNA)were scored at day 7 after birth. The incidence of brain injury based on single parameter was calculated. Results:Conventional MRI showed symmetrical high signal of TWI in globus pallidus of 12 patients,of which Multi-voxel 1H-MRS revealed that the relative concentrations of NAA/Cr and Cho/Cr were much lower than the others,but there was no significant difference in the relative concentrations of Cho/NAA. The incidences of brain damage dignozed by a single parameter were as follows:clinic diagnosis 22.2%,MRI 33.3%,MRS 41.7%,NBNA 38.9%,S100B 36.11%,respectively. Conclusion:Combination of MRI and MRS,will be more helpful for early diagnosis of brain damage due to hyperbilirubinemia and provides reliable clinical evidence for early intervention.
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