DTI技术测定新生儿病理性黄疸患儿小脑齿状核FA VR与病情的关系及预测ABE价值

doi:10.3969/j.issn.1006-6233.2021.03.027

Abstract
Figure/Table
References
Related Citation (0)

Download: PDF (1780 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To analyze the relation between the severity of the disease and magnetic resonance diffusion tensor imaging (DTI) technology in determining fractional anisotropy (FA) and volume reconstructio (VR) of the cerebellar dentate nucleus in children with neonatal pathological jaundice and to analyze the value of predicting the occurrence of acute bilirubin encephalopathy (ABE). Methods: A total of 85 children with simple neonatal pathological jaundice in our hospital from June 2018 to June 2020 were selected as the jaundice group,and 73 children with neonatal pathological jaundice secondary to ABE during the same period were selected as the ABE group. All have been tested by DTI technology. The general information,disease severity,neonatal behavioral neurological assessment (NBNA) score,laboratory indicators [total bile acid (TBA),total bilirubin (TSB),direct bilirubin (DBil),alanine aminotransferase (ALT),γ-glutamyltransferase (GGT)] levels,FA and VR in the cerebellar dentate nucleus were compared between the two groups. The relationship between FA and VR of cerebellar dentate nucleus and the severity of pathological jaundice,NBNA score,laboratory indicators and the occurrence of ABE were analyzed,and the predictive value of FA and VR of cerebellar dentate nucleus on the occurrence of ABE was evaluated. Results: There was a statistically significant difference in the degree of illness and NBNA score between the two groups (P<0.05). The TSB,DBil,TBA and VR of the cerebellar dentate nucleus in the ABE group were higher than those in the jaundice group,and the FA of the cerebellar dentate nucleus was shorter than that in the jaundice group (P<0.05). The FA of the cerebellar dentate nucleus in children with neonatal pathological jaundice was positively correlated with the NBNA score,and negatively correlated with the severity of the disease; TSB,DBil,and TBA. The VA of the cerebellar dentate nucleus was negatively correlated with the NBNA score,and positively correlated with the severity of the disease,TSB,DBil,and TBA (P<0.05). The severity of illness,NBNA score,TSB,cerebellar dentate nucleus FA,VR and ABE were significantly correlated (P<0.05). The combination of FA and VR in the cerebellar dentate nucleus predicted the highest AUC in ABE,which was 0.810,and the sensitivity and specificity were 71.23% and 78.82%,respectively. Conclusion: The FA and VR of the cerebellar dentate nucleus are significantly correlated with the severity of neonatal pathological jaundice. Early detection of FA and VR of the cerebellar dentate nucleus by DTI can provide effective auxiliary means for clinical evaluation of the severity of the disease and predicting the occurrence of ABE.

Key words： Magnetic resonance diffusion tensor imaging technique Neonatal pathological jaundice Cerebellar dentate nucleus Fractional anisotropy Volume reproduction Acute bilirubin encephalopathy

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors

Cite this article:

URL:

http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.03.027 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I3/480

[1] 贾南,贾毅,何薇,等.新生儿病理性黄疸病原菌分布特征、耐药性分析及相关炎症因子水平检测[J].中国病原生物学杂志,2019,14(9):1088~1090,1095.
[2] Helal NF,Ghany EAGA,Abuelhamd WA,et al.Characteristics and outcome of newborn admitted with acute bilirubin encephalopathy to a tertiary neonatal intensive care unit[J].World Pediatr,2019,15(1):42~48.
[3] Yan R,Han D,Ren J,et al.Diagnostic value of conventional MRI combined with DTI for neonatal hyperbilirubinemia[J].Pediatr Neonatol,2018,59(2):161~167.
[4] van Toorn R,Brink P,Smith J,et al.Bilirubin-induced neurological dysfunction:a clinico-radiological-neurophysiological correlation in 30 consecutive children[J].Child Neurol,2016,31(14):1579~1583.
[5] 《中华儿科杂志》编辑委员会,中华医学会儿科学分会新生儿学组.新生儿黄疸诊疗原则的专家共识[J].中华儿科杂志,2010,48(9):685~686.
[6] Barlow J,Herath NI,Bartram Torrance C,et al.The Neonatal behavioral assessment scale (NBAS) andnewborn behavioral observations (NBO) system for supporting caregivers and improving outcomes in caregivers and their infants[J].Cochrane Database Syst Rev,2018,3(3):CD011754.
[7] 陈清,钱霜霜,林锋.NSE联合NPY对新生儿高胆红素血症脑损伤早期诊断的临床意义[J].重庆医学,2019,48(10):1784~1786.
[8] Bech LF,Donneborg ML,Lund AM,et al.Extreme neonatal hyperbilirubinemia,acute bilirubin encephalopathy and kernicterus spectrum disorder in children with galactosemia[J].Pediatr Res,2018,84(2):228~232.
[9] 蔡艳华,陈梅.新生儿急性胆红素脑病颅脑MRI特征改变的临床意义[J].中国实用医药,2018,13(18):37~38.
[10] 尹家瑜,申炜,许梅海,等.苍白球与壳核T1WI信号比值在足月儿急性高胆红素相关脑病的临床研究[J].实用放射学杂志,2019,35(3):433~436.
[11] Wisnowski JL,Panigrahy A,Painter MJ,et al.Magnetic resonance imaging of bilirubin encephalopathy:current limitations and future promise[J].Semin Perinatol,2014,38(7):422~428.
[12] Malik GK,Trivedi R,Gupta RK,et al.Serial quantitative diffusion tensor MRI of the term neonates with hypoxic-ischemic encephalopathy (HIE)[J].Neuropediatrics,2006,37(6):337~343.
[13] 肖斌,谭长连.基于小脑齿状核的新生儿高胆红素血症脑损伤的DTI研究[J].中国医师杂志,2019,21(7):989~992,996.
[14] 张建良. 足月新生儿高胆红素血症潜在颅脑损伤的MR-DTI研究[D].湖南师范大学,2018,17~20.
[15] 邓敏,何四平,伍光春,等.胆红素脑病所致听力受损患儿听觉通路纤维束的DTI研究:各向异性分数和其他扩散系数的变化[J].临床放射学杂志,2017,36(11):1679~1683.