新生儿胆红素脑病的MRI表现

目的 探讨磁共振成像(MRI)对新生儿胆红素脑病(NBE)诊断的价值.方法 回顾性分析28例胆红素脑病新生儿的常规MRI表现和临床资料.结果 28例患儿中27例T1WI苍白球对称性高信号.19例患儿底丘脑T1WI呈高信号,T2WI呈等信号,主要表现为底丘脑点状或"八"字形对称性短T1WI信号.8例患儿中脑、桥脑背侧、延髓T1WI呈高信号,而桥脑腹侧信号正常.扩散加权成像(DWI)显示所有胆红素脑病患儿的基底节无异常信号.结论 常规MRI及DWI有助于新生儿胆红素脑病的诊断.     

新生儿急性胆红素脑病的低场磁共振表现

目的 探讨急性胆红素脑病在低场磁共振的MRI表现.方法回顾分析15例急性胆红素脑病患儿的头颅MRI图像,同期的8例正常新生儿头颅MRI作对照.结果 15例急性胆红素脑病中,10例双侧苍白球T1WI呈对称性高信号,T2WI呈正常的稍高信号,其余5例未见明显异常.结论 低场MRI可较好地显示高胆红素血症对基底节苍白球的损伤,双侧苍白球T1WI对称性高信号是新生儿急性胆红素脑病的重要特征.     

新生儿胆红素脑病MRI特征的研究

目的 探讨新生儿胆红素脑病(NBE)MRI特征.方法 回顾性分析17例NBE患儿的常规MRI和临床资料,评价苍白球及底丘脑信号高低,并根据底丘脑有无高信号分为底丘脑高信号组和无高信号组,对苍白球信号强度的增加值与血清总胆红素的峰值进行Pearson相关性分析,采用t检验比较底丘脑高信号组和无高信号组血清总胆红素峰值水平.结果 17例患儿中15例有T1 WI苍白球对称性高信号,1例表现为T1 WI苍白球后部对称性高信号.9例患儿底丘脑T1 WI呈高信号,T2 WI呈等信号,主要表现为底丘脑点状或八字形对称性短T1信号.4例患儿中脑、桥脑背侧、延髓T1 WI呈高信号,而桥脑腹侧信号正常.使用1.0 T MR仪扫描的12例患儿苍白球信号强度增加值为249.0～423.8,血清总胆红素峰值为366.0～983.3μmol/L,两者呈正相关(r=0.676,P＜0.05).底丘脑高信号组9例,无高信号组8例,血清总胆红素分别为(660.7±192.4)、(513.3±1cr7.5)μmol/L,2组差异无统计学意义(t=1.914,P＞0.05).结论 NBE的MRI表现有一定特征性,有助于NBE的诊断.     

MRI及1H-MRS对新生儿胆红素脑病的诊断研究进展

胆红素脑病,原称核黄疸,是新生儿时期由严重的高胆红素血症导致的中枢神经系统损伤性疾病。磁共振成像及磁共振波谱成像作为一种无创性检查手段,     

DWI及常规MR在新生儿高胆红素血症及胆红素脑病诊断中的应用

目的 探讨DWI及常规MR在新生儿高胆红素血症及胆红素脑病诊断中的应用.方法 分析19例新生儿高胆红素血症及13例新生儿胆红素脑病患儿和8例健康新生儿(对照组)DWI及常规MR检查资料.结果 新生儿胆红素脑病常规MR表现:T1加权像可见苍白球对称性高信号,T2加权像可见苍白球呈等信号,13例病人中12例有此项MR表现,另外有6例新生儿胆红素脑病患儿底丘脑在T1加权像呈高信号,T2加权像呈等信号.13例新生儿胆红素脑病患儿苍白球及底丘脑DWI及ADC图信号均未见异常.19例高胆红素血症患儿苍白球及底丘脑T1加权像、T2加权像及DWI信号均未见异常.新生儿胆红素脑病组基底节区和丘脑ADC值较对照组和高胆红素血症组相比均稍微升高,但是3组差别无统计学意义(P＞0.05).结论 常规磁共振检查对从新生儿高胆红素血症患儿中早期发现新生儿胆红素脑病患儿并对新生儿胆红素脑病早期诊断可提供有益的帮助.DWI对于新生儿胆红素脑病患儿的早期诊断没有意义.     

胆红素脑病的MRI诊断

目的 探讨MRI对胆红素脑病的诊断和预后判断价值.方法 分析26例临床确诊为胆红素脑病患儿的MRI特点,MRI采用GE Signa EXCITE1.5T超导型磁共振扫描系统,扫描图像包括T1WI、T2WI和DWI,由2名放射科医师采用单盲法分析MR图像.结果 首次检查9例为新生儿,8例表现为双侧苍白球对称性T1WI高信号,5例伴丘脑腹外侧对称稍高信号;2例双侧苍白球对称性T2WI稍高信号.1个月以上随访的25例(25/26)均表现为双侧苍白球对称性T2WI高信号,4例T1WI呈低信号,1例T1WI呈稍高信号;25例DWI未见明显异常信号改变.1例3个月后 DWI呈高信号,而11个月时DWI高信号消失,所见双侧苍白球对称T2WI高信号也消失.结论 胆红素脑病患儿的MR影像具有特征性,可为临床早期诊断及预后判断提供重要信息.     

新生儿缺血缺氧性脑病的MRI表现临床价值分析

新生儿缺血缺氧性脑病(hypoxic ischemic enceph-alopathy,HIE)是指新生儿在围生期由于窒息出现脑组织缺氧或脑血流减少或缺失,导致脑血供和气体交换障碍.若不进行及时诊断和救治,将会出现胎儿宫内窘迫、心率异常,分娩困难,呼吸困难等,将最终导致患儿的全脑性的不可逆损伤,是发生新生儿智力伤残甚至死亡的主要原因[1～3].     

新生儿缺氧缺血性脑病的MRI评价

目的：评价MRI对新生儿缺氧缺血性脑病（HIE）的诊断价值。资料与方法：采用SE序列对61例（65例次）HIE患儿进行了MRI检查，分析MRI表现。结果：56例新生儿期检查中脑水肿42例，内囊后肢信号异常22例，脑出血11例，脑室出血4例，脑室旁白质软化2例。9例婴儿期检查者中表现有脑室扩大7例，脑外间隙增宽9例，髓鞘发育延迟3例。结论：MRI有助于明确HIE的脑损伤情况，对于预后的评估有价值。     

非酒精性急性Wernicke 脑病的临床及MRI特点

目的 探讨非酒精性急性Wernicke 脑病的临床及MRI表现.方法 回顾分析6例非酒精性急性Wernicke 脑病的临床与MRI所见.均为女性,年龄21~75岁,平均45岁.无嗜酒史.使用GE 1.5T MR扫描仪,行常规T1WI、T2WI、T2FLAIR、DWI扫描,2例行增强扫描.结果 6例均有2周以上呕吐及不能进食史.起病急,首发症状均为精神异常及意识障碍,其中2例发病后即进入昏迷状态.其他症状有眼部症状4例,共济失调1例.MRI表现:6例均有双侧对称性第三脑室旁、丘脑内侧、大脑导水管周围、中脑被盖长T1长T2异常信号.其他部位信号异常的有第四脑室底部4例,桥脑延髓3例,乳头体3例.DWI病灶区呈扩散受限的高信号.增强扫描病灶边缘有强化.经大剂量维生素B1治疗,临床好转5例,死亡1例.结论 非酒精性急性Wernicke 脑病有特征性的MRI表现,是诊断本病的重要影像学方法.     

足月新生儿低血糖脑病的MRI表现

目的 探讨足月新生儿低血糖脑病的MRI表现.方法 回顾性分析16例低血糖脑病的MR资料,其中男10例,女6例,所有病例均在患者出生后6 d内进行,包括常规T1WI,T2WI和Flair,DWI扫描.其中4例1~3月后再次复查MR.结果 16例首次检查T1异常8例,表现为皮层下白质呈低信号,4例皮层呈高信号.T2异常6例,表现为高信号区.DWI异常12例,表现为对称性高信号区.分布部位:双侧顶枕叶10例,胼胝体压部4例,双额叶1例,双屏状核1例,侧脑室旁白质4例,小脑上脚、脑干腹侧1例.1~3月后复查4例,有2例表现为局限性脑皮层萎缩,胼胝体变细.结论 足月新生儿低血糖脑损伤最易发生顶枕叶后部脑组织,其次胼胝体,小脑亦可受累.DWI上对称性高信号具有一定的特征性.     

MRI及MRS对新生儿急性胆红素脑病的诊断效能比较

目的:探讨MRI及MRS对新生儿急性胆红素脑病的诊断效能,并进行比较。方法:回顾性分析我院收治的高胆红素血症患儿198例的临床资料,依据是否发生急性胆红素脑病分为脑病组和危险组,同期选取健康新生儿30例作为对照组。所有研究对象均行MRI及MRS分析N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr),并以临床诊断为对照,统计分析MRI及MRS结果。结果:MRI示急性胆红素脑病患儿苍白球区主要以T_1WI呈高信号为特征,T_2WI呈等或高信号;DWI未见特殊变化(均呈等信号);MRS示急性胆红素脑病患儿可见Cho峰、NAA峰及Cr峰,但NAA峰普遍较低,部分患儿NAA峰明显低于Cr峰。ROC曲线显示,MRI诊断新生儿急性胆红素脑病的敏感度、特异度、准确度分别为84.33%、88.28%、86.84%,分别低于MRS的93.98%、95.17%、94.74%(均P0.05)。结论:MRI及MRS对诊断新生儿急性胆红素脑病均有良好的敏感度、特异度和准确度,但MRS诊断效能更高,有利于为临床早期干预提供更可靠证据。     

Studying neonatal bilirubin encephalopathy with conventional MRI,MRS, and DWI

Introduction  The purpose of this study was to evaluate the diagnostic value of conventional magnetic resonance imaging (MRI), proton magnetic resonance spectroscopy (¹H-MRS), and diffusion-weighted imaging (DWI) for neonatal bilirubin encephalopathy. Methods  We collected conventional MRI in 24 neonates with neonatal bilirubin encephalopathy. We performed ¹H-MRS and DWI sequences to nine of the 24 patients and seven age-matched healthy control subjects. Multiple-voxel ¹H-MRS data were acquired using PRESS pulse sequence with TE = 135 ms and TR = 1500 ms. The spectroscopic regions of interest were the bilateral basal ganglia and thalamus with a 1.0 mL spatial resolution. The data from DWI were collected by using a single shot-spin echo-echo planar imaging sequence with TR/TE: 2900/98, and imaging regions were also focused on the bilateral basal ganglia and thalamus. Results  Nineteen of the 24 patients had abnormal T₁-weighted image hyperintensity in the globus pallidus, but these lesions appeared as normal T₂-weighted image intensity in the same region. Ten of the 24 patients had T₁-weighted image high signal intensity in the subthalamic nucleus and appeared as normal intensity in the region for the T₂-weighted images. The peak area ratios of NAA/Cho and NAA/Cr were significantly decreased (t-test, P < 0.05) in the patients compared to the controls in the basal ganglia. Conclusion  Conventional MR imaging and ¹H-MRS are important complementary tools in the diagnosis of neonatal bilirubin encephalopathy. The study provides important information for applying these MR modalities to evaluate neonates with bilirubin encephalopathy.     

MRI of neonatal encephalopathy

We present the magnetic resonance imaging (MRI) findings in neonatal encephalopathy, including hypoxic-ischaemic encephalopathy, perinatal/neonatal stroke, metabolic encephalopathy from inborn errors of metabolism, congenital central nervous system infections and birth trauma. The applications of advanced MRI techniques, such as diffusion-weighted imaging and magnetic resonance spectroscopy are emphasized.     

Diffusion-weighted imaging of patients with neonatal bilirubin encephalopathy

Purpose

The aim of the study is to evaluate neonatal bilirubin encephalopathy in the acute period by the DWI.

Materials and methods

Thirty newborn babies with hyperbilirubinemia at the gestational age of 38–40 weeks, diagnosed with acute neonatal bilirubin encephalopathy as a result of clinical findings were included in the study, and a further 24 newborn babies, whose ages, weights and gestational ages were equalized, were regarded as a control group. DWI was performed on both patient and control groups.

Results

When DWI apparent diffusion coefficients (ADC) of both neonatal bilirubin encephalopathy patients and the control group were compared, ACD values of neonatal bilirubin encephalopathy patients were found to be statistically significantly highly compared to that of the control group (p < 0.001). There was a significant correlation between bilirubin values and DWI findings (r = 0.41, p < 0.05).

Conclusion

The ADC measurement could be a promising parameter in detecting neonatal bilirubin encephalopathy.     

急性胆红素脑病常规MRI及1H-MR波谱表现

Objective To investigate the characterized imaging in conventional MRI, get information about the metabolites in basal ganglia from proton MR Spectroscopy(1H-MRS) of acute bilirubin encephalopathy(ABE) and find out the relationship between those changes and bilirubin levels. Methods Twenty-eight patients with acute bilirubin encephalopathy and 15 normal neonates underwent MR and 1H-MRS examinations T1 WI, T2WI and DWI were collected via conventional MRI scanning of all neonates. All patients underwent multi-voxels scanning and 15 of them had single voxel scanning. 1H-MRS used point resolved spectroscopy (PRESS) both in multi-voxels and single voxel scanning. The data of them were acquired from the ROIs placed in basal ganglia and globus pallidus, respectively. The metabolites including NAA choline, Lactate, glutamate and glutamine, myoinositol and creatine were quantitatively analyzed to compare them between the control group and the case group. Equality of variance between patient data and normal values were tested by using the two-tailed t test. The case group was divided into three groups of 342.0 μmol/L < TSB ≤ 427. 5 μmol/L,427.5 μmol/L < TSB ≤ 513.0 μmol/L, TSB > 513.0 μmol/L including 8,9,11 patients, respectively. Analysis of variance was used for statistics. Results Conventional magnetic resonance imaging showed symmetrical high signal of T1WI in globus pallidus of 23 patients. The case group and the control group were significantly different. Single voxel 1H-MRS revealed that the relative concentrations of Glx/Gr and mI/Cr in the control group were 0.95±0.23, 0.57±0.20, respectively, While those in case group were 1.45±0.37, 0.74±0.23, respectively. There were significant differences between two groups (t =2. 13,4. 40,P =0.04,0.00 respectively). Multi-voxels scanning 1H-MRS revealed that Glx / Cr were 0.51±0.36 in case group and 0.29±0.18 in control group. There was also a significant difference between two groups (t =2.17,P =0.03). And the values of Cho/Cr, NAA/Cr and Lac/Cr were not significantly different. The results were same in multi-voxels 1H-MRS. Total bilirubin level and the concentration of metabolites in the brain do not have obvious correlation. Conclusions ABE has a characteristic signature which is symmetrical high signal of T1 WI in globus pallidus on conventional MBI; The values of mI/Cr and Glx/Cr remarkably increase as detected by 1H-MRS, which is generally in agreement with what has been known about bilirubin pathology.     

新生儿缺氧缺血性脑病的MRI研究

缺氧缺血性脑病(HIE)是小儿智力、发育落后以及脑瘫等病残的主要原因。由于损伤时脑的成熟度、血氧降低的程度、损伤持续时间的不同,脑损伤的表现也不同,因此准确地判定HIE的严重度和损伤部位需依靠超声、CT和MRI等影像学方法,尤其新的MRI技术,从脑形态及功能学方面为观察HIE提供了新视角,在早期诊断、监测干预治疗、预测疗效等方面显示出广阔的应用前景。