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The Relationship Between FA,VR of Cerebellar Dentate Nucleus and the Condition of Neonatal Pathological Jaundice by DTI Technique and Its Value in Predicting ABE |
HUANG Kaiping, et al |
Children's Hospital Affiliated to Chongqing Medical University, Chongqing 400014, China |
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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.
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