Diagnostic and Intervention Radiology Department, Cairo University Hospitals, Kasr Al-Ainy, El-Manial, Cairo, 11956, Egypt.
Pediatric Department, Abu El Reesh Hospital, Kasr Al-Ainy, Cairo, Egypt.
J Ultrasound. 2023 Mar;26(1):175-184. doi: 10.1007/s40477-022-00704-0. Epub 2022 Aug 15.
To evaluate the difference in cerebral blood flow in neonates with and without extreme unconjugated hyperbilirubinemia.
Transcranial Doppler parameters of 26 full term newborns with extreme unconjugated hyperbilirubinemia (UCH) were compared to 13 postnatal age and sex matched normal healthy neonates serving as controls. Resistance index (RI), pulsatility index (PI) and peak systolic velocity (PSV) were measured in the middle cerebral, internal carotid and posterior cerebral arteries on both sides by transcranial color Doppler ultrasound.
An increase in cerebral blood flow (decreased RI, PI and increased PSV) was observed in the extreme unconjugated hyperbilirubinemia (UCH) group. There was positive correlation between total serum bilirubin level and peak systolic velocity and vice versa with resistivity and pulsatility indices. Eight neonates developed clinical features of acute bilirubin encephalopathy and showed significantly increased peak systolic velocity in the right middle cerebral artery compared to those with normal outcome. Resistivity index and pulsatility index were lower in patients managed by exchange transfusion compared to those managed with phototherapy.
An increase in cerebral blood flow was observed in neonates with UCH compared to those without hyperbilirubinemia. By assessing the cerebral blood flow velocity, resistivity index (RI), and pulsatility index (PI) of particular intracranial arteries, the transcranial Doppler can identify the at-risk neonates, for development of neurological affliction in extreme unconjugated hyperbilirubinemia.
评估伴有和不伴有极重度未结合高胆红素血症的新生儿脑血流的差异。
将 26 例极重度未结合高胆红素血症（UCH）足月新生儿的经颅多普勒参数与 13 例年龄和性别匹配的正常健康新生儿进行比较，作为对照组。通过经颅彩色多普勒超声测量双侧大脑中动脉、颈内动脉和大脑后动脉的阻力指数（RI）、搏动指数（PI）和收缩期峰值速度（PSV）。
UCH 组脑血流增加（RI、PI 降低，PSV 增加）。总血清胆红素水平与收缩期峰值速度呈正相关，与阻力指数和搏动指数呈负相关。8 例新生儿出现急性胆红素脑病的临床特征，右侧大脑中动脉的收缩期峰值速度明显高于预后正常的新生儿。与光疗相比，换血治疗的患者阻力指数和搏动指数较低。
与无高胆红素血症的新生儿相比，UCH 新生儿的脑血流增加。通过评估特定颅内动脉的脑血流速度、阻力指数（RI）和搏动指数（PI），经颅多普勒可以识别极重度未结合高胆红素血症中易发生神经损伤的新生儿。
