Lin Qihuan, Chen Lanmei, Zheng Hongyi, Tan Hui, Zhang Gengbiao, Zheng Wenbin
Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
Department of Radiology, The Second Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, China.
Front Neurosci. 2023 Mar 28;17:1110349. doi: 10.3389/fnins.2023.1110349. eCollection 2023.
To investigate the significance of proton magnetic resonance spectroscopy (H-MRS) and glutamate chemical exchange saturation transfer (Glu-CEST) techniques in assessing the condition and prognosis of acute bilirubin encephalopathy patients and to understand the mechanism of nerve injury in this disease.
From September 2019 to February 2021, 31 neonates with acute bilirubin encephalopathy and 16 healthy neonates were enrolled in this study. All the quantitative results of H-MRS, Glu-CEST, and conventional magnetic resonance imaging (MRI) of all neonates were analyzed. The associations between statistically significant indicators of imaging and developmental quotients (DQ) were analyzed.
The 31 cases were assigned to the mild subgroup ( = 21) and moderate and severe subgroup ( = 10) according to the bilirubin-induced neurologic dysfunction (BIND) scores. The case group had elevated Cho and GABA absolute concentrations compared to the normal control group (all < 0.05). Compared with the normal control group, the absolute concentration of GABA of the moderate and severe subgroup was significantly larger ( < 0.05). Compared with the normal control group, the Glu-CEST% values in the left basal ganglia, right thalamus, left frontal cortex and bilateral medial geniculate body of the case group was significantly larger (all < 0.05). The moderate and severe subgroup had higher Glu-CEST% values in the left basal ganglia, right thalamus, and bilateral medial geniculate body than the normal control group (all < 0.05). A negative association was revealed between the DQ scores and the Glu-CEST% values in the left basal ganglia ( = -0.888, < 0.05).
The combination of H-MRS and Glu-CEST techniques can monitor the intracerebral metabolite level of acute bilirubin encephalopathy and evaluate the illness severity.
探讨质子磁共振波谱（H-MRS）和谷氨酸化学交换饱和转移（Glu-CEST）技术在评估急性胆红素脑病患者病情及预后中的意义，并了解该疾病神经损伤的机制。
选取2019年9月至2021年2月期间收治的31例急性胆红素脑病新生儿及16例健康新生儿作为研究对象。分析所有新生儿的H-MRS、Glu-CEST及常规磁共振成像（MRI）的各项定量结果。分析具有统计学意义的影像学指标与发育商（DQ）之间的相关性。
根据胆红素诱导的神经功能障碍（BIND）评分，将31例患儿分为轻度亚组（=21）和中重度亚组（=10）。病例组Cho和GABA绝对浓度高于正常对照组（均<0.05）。与正常对照组相比，中重度亚组的GABA绝对浓度显著升高（<0.05）。与正常对照组相比，病例组左侧基底节、右侧丘脑、左侧额叶皮质及双侧内侧膝状体的Glu-CEST%值显著升高（均<0.05）。中重度亚组左侧基底节、右侧丘脑及双侧内侧膝状体的Glu-CEST%值高于正常对照组（均<0.05）。左侧基底节的DQ评分与Glu-CEST%值呈负相关（=-0.888，<0.05）。
H-MRS与Glu-CEST技术联合应用可监测急性胆红素脑病患儿脑内代谢物水平，评估病情严重程度。
