苍白球T1WI信号强度联合MRS图像在新生儿HB病情诊断中的应用

doi:10.7517/issn.1674-0475.220330

影像科学与光化学 ›› 2022, Vol. 40 ›› Issue (5): 1274-1279.DOI: 10.7517/issn.1674-0475.220330

苍白球T1WI信号强度联合MRS图像在新生儿HB病情诊断中的应用

康志雷, 杜乃熠, 刘朝艳, 李洋, 姜立杰

衡水市人民医院影像中心, 河北衡水 053000

收稿日期:2022-03-28 发布日期:2022-09-13
通讯作者: 姜立杰
基金资助:
2019年河北省医学科学研究课题计划（20191779）

Application of T1WI Signal Intensity of Globus Pallidus Combined with MRS Image in the Diagnosis of Neonatal HB

KANG Zhilei, DU Naiyi, LIU Zhaoyan, LI Yang, JIANG Lijie

Image Center of Hengshui People's Hospital, Hengshui 053000, Hebei, P. R. China

Received:2022-03-28 Published:2022-09-13

摘要/Abstract

摘要： 探讨苍白球T1加权像（T1WI）信号强度联合磁共振波谱成像（MRS）图像对新生儿高胆红素血症（HB）病情的鉴别诊断价值及与血清胆红素（TsB）、经皮胆红素（TcB）相关性分析。选取132例新生儿HB患儿，根据血清TsB水平分为轻度组、中度组和重度组，其中有42例并发急性胆红素脑病患儿，另选取47例同期健康新生儿作为对照组。均行磁共振检查获取苍白球T1WI信号强度、MRS图像相关指标[N-乙酰天冬氨酸（NAA）/肌酸复合物（Cr）、胆碱复合物（Cho）/Cr、Cho/NAA]。结果显示，左侧苍白球T1WI信号强度、右侧苍白球T1WI信号强度、Cho/Cr、Cho/NAA比较，重度组>中度组>轻度组>对照组，NAA/Cr重度组<中度组<轻度组<对照组（P<0.05）；HB患儿左、右侧苍白球T1WI信号强度均与NAA/Cr呈负相关，与Cho/Cr、Cho/NAA呈正相关（P<0.05）；左侧苍白球T1WI信号强度、右侧苍白球T1WI信号强度、NAA/Cr、Cho/Cr、Cho/NAA联合诊断新生儿HB病情的曲线下面积（AUC）为0.901；并发急性胆红素脑病患儿治疗后左侧、苍白球T1WI信号强度右侧苍白球T1WI信号强度、Cho/Cr、Cho/NAA均高于对照组，NAA/Cr低于对照组（P<0.05）。可见，苍白球T1WI信号强度联合MRS图像在新生儿HB病情诊断方面具有较高敏感度和特异度，早期检测可辅助临床开展相关防治措施。

关键词: 新生儿高胆红素血症, 苍白球T1WI信号强度, 磁共振波谱成像, 经皮胆红素, 血清胆红素

Abstract: This paper investigated the differential diagnostic value of globus pallidus T1-weighted image (T1WI) signal intensity combined with magnetic resonance spectroscopy (MRS) images for neonatal hyperbilirubinemia (HB) condition, and the correlation analysis with serum bilirubin (TsB) and transcutaneous bilirubin (TcB). 132 neonates with HB were selected, and according to the serum TsB level they were divided into mild, moderate and severe groups. Among them there were 42 cases of children with concomitant acute bilirubin encephalopathy, and 47 healthy neonates at the same time were selected as the control group. All neonates were performed magnetic resonance examination to obtain globus pallidus T1WI signal intensity and MRS image related indexes[N-ethylphthalate aspartate (NAA)/creatine complex (Cr), choline complex (Cho)/Cr, Cho/NAA]. The results showed that the T1WI signal intensity of the left and right globus pallidus, Cho/Cr, Cho/NAA in the severe group > moderate group > mild group > control group, and the NAA/Cr in the severe group < moderate group < mild group < control group (P<0.05). The T1WI signal intensity of the left and right globus pallidus in children with HB were negatively correlated with NAA/Cr and positively correlated with Cho/Cr and Cho/NAA (P<0.05). The area under the curve (AUC) of left globus pallidus T1WI signal intensity, right globus pallidus T1WI signal intensity, NAA/Cr, Cho/Cr, Cho/NAA combined diagnosis of neonatal HB was 0.901. The signal intensity of left and right globus pallidus T1WI, Cho/Cr, Cho/NAA were higher in children with concomitant acute bilirubin encephalopathy after treatment were higher than those of the control group, and the NAA/Cr were lower than those of the control group (P<0.05). It can be seen that the T1WI signal intensity of the globus pallidus combined with MRS images has high sensitivity and specificity in the diagnosis of HB in newborns, and the early detection can assist in the clinical prevention and treatment measures.

Key words: neonatal hyperbilirubinemia, T1WI signal intensity of globus pallidus, magnetic resonance spectroscopy imaging, transcutaneous bilirubin, total serum bilirubin

康志雷, 杜乃熠, 刘朝艳, 李洋, 姜立杰. 苍白球T1WI信号强度联合MRS图像在新生儿HB病情诊断中的应用[J]. 影像科学与光化学, 2022, 40(5): 1274-1279.

KANG Zhilei, DU Naiyi, LIU Zhaoyan, LI Yang, JIANG Lijie. Application of T1WI Signal Intensity of Globus Pallidus Combined with MRS Image in the Diagnosis of Neonatal HB[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(5): 1274-1279.

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苍白球T1WI信号强度联合MRS图像在新生儿HB病情诊断中的应用

Application of T1WI Signal Intensity of Globus Pallidus Combined with MRS Image in the Diagnosis of Neonatal HB

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