Xu Jun, Yang Du-Jiao, Huang Fu-Rong, Zhang Ai-Min
Department of Neonatology, Hunan Provincial People's Hospital, Changsha 410000, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2020 Jul;22(7):711-715. doi: 10.7499/j.issn.1008-8830.2003139.
To study the value of fractional anisotropy (FA) of regions of interest (ROI) on magnetic resonance diffusion tensor imaging (DTI) in bilirubin-induced neurological dysfunction in neonates.
A total of 91 neonates with hyperbilirubinemia who were hospitalized from January 2017 to January 2018 were enrolled. According to the peak level of total serum bilirubin, they were divided into three groups: mild/moderate increase (n=45), severe increase (n=35), and extremely severe increase (n=11). According to the presence or absence of abnormal neurological manifestations, they were divided into two groups: neurological dysfunction (n=20) and non-neurological dysfunction (n=71). Ten healthy full-term infants were enrolled as the control group. Head DTI was performed for all neonates to measure the FA values of the bilateral globus pallidus, the anterior limb of the internal capsule, the posterior limb of the internal capsule, and the cerebellar dentate nucleus.
The extremely severe increase group had significantly lower FA values of the globus pallidus than the control, mild/moderate increase, and severe increase groups (P<0.05). The severe increase group had significantly lower FA values of the globus pallidus than the control group (P<0.05). The extremely severe increase group had significantly lower FA values of the posterior limb of the internal capsule than the control, mild/moderate increase, and severe increase groups (P<0.05). The neurological dysfunction group had significantly lower FA values of the globus pallidus and the posterior limb of the internal capsule than the non-neurological dysfunction group (P<0.05).
Serum bilirubin level combined with the changes in the DTI FA values of the globus pallidus and the posterior limb of the internal capsule can be used to predict the injury of cerebral nuclei and white matter fibers.
探讨磁共振扩散张量成像（DTI）感兴趣区（ROI）的分数各向异性（FA）值在新生儿胆红素诱导的神经功能障碍中的价值。
选取2017年1月至2018年1月住院的91例高胆红素血症新生儿。根据血清总胆红素峰值水平，将其分为三组：轻度/中度升高组（n = 45）、重度升高组（n = 35）和极重度升高组（n = 11）。根据有无异常神经表现，将其分为两组：神经功能障碍组（n = 20）和非神经功能障碍组（n = 71）。选取10例健康足月儿作为对照组。对所有新生儿进行头部DTI检查，测量双侧苍白球、内囊前肢、内囊后肢和小脑齿状核的FA值。
极重度升高组苍白球的FA值显著低于对照组、轻度/中度升高组和重度升高组（P < 0.05）。重度升高组苍白球的FA值显著低于对照组（P < 0.05）。极重度升高组内囊后肢的FA值显著低于对照组、轻度/中度升高组和重度升高组（P < 0.05）。神经功能障碍组苍白球和内囊后肢的FA值显著低于非神经功能障碍组（P < 0.05）。
血清胆红素水平联合苍白球和内囊后肢DTI的FA值变化可用于预测脑核团和白质纤维的损伤。
