MRI多序列扫描在早产儿高胆红素血症脑损伤诊断及严重程度评估中的价值观察

目的观察磁共振成像(MRI)多序列扫描在早产儿高胆红素血症脑损伤诊断与病情严重程度评估中的应用价值。方法选取我院82例早产儿高胆红素血症患者,予以新生儿行为神经测定(NBNA),依据血清胆红素检测浓度分为轻度组(n=34)、中度组(n=28)与重度组(n=20),并取同期82例正常新生儿为对照组,均进行MRI多序列扫描,观察MRI对早产儿高胆红素血症脑损伤诊断准确性,比较MRI异常患者与MRI正常患者NBNA评分、不同病情组与对照组MRI表现。结果MRI诊断早产儿高胆红素血症脑损伤灵敏度90.32%,特异度90.00%,准确性90.24%,kappa值0.752;MRI异常患者NBNA评分明显低于MRI正常患者(P<0.05);左右侧苍白球平均信号:轻度组与对照组比较无显著差异(P>0.05),不同病情组为:重度组>中度组>轻度组,组间比较差异显著(P<0.05);4组左右侧苍白球平均信号-同侧额叶白质平均信号比较无显著差异(P>0.05)。结论MRI多序列扫描诊断早产儿高胆红素血症脑损伤准确性高,可为患儿病情严重程度评估提供可靠依据,应用价值高。

Value of MRI Multi-sequence Scan in Diagnosis of Brain Injury and Severity Assessment of Premature Infants with Hyperbilirubinemia

Objective To observe the application value of magnetic resonance imaging(MRI)multi-sequence scan in the diagnosis of brain injury and severity assessment of premature infants with hyperbilirubinemia.Methods Eighty-two premature infants with hyperbilirubinemia in the hospital were enrolled for neonatal behavioral neurological assessment(NBNA).According to different concentrations of serum bilirubin,they were divided into mild group(n=34),moderate group(n=28)and severe group(n=20).And 82 normal neonates in the same period were enrolled as a control group.All underwent MRI multi-sequence scan.The diagnostic accuracy of MRI for brain injury in preterm infants with hyperbilirubinemia was observed.NBNA scores between patients with abnormal and normal MRI and MRI findings between different-disease group and control group were compared.Results The sensitivity,specificity,accuracy and kappa value of MRI for diagnosis of brain injury in preterm infants with hyperbilirubinemia were 90.32%,90.00%,90.24%,and 0.752,respectively.NBNA scores in patients with abnormal MRI were significantly lower than those with normal MRI(P<0.05).There was no significant difference in average signals of left and right globus pallidus between the mild and control groups(P>0.05).The above signals were the highest in severe groups,followed by the moderate and mild groups(P<0.05).There were significant differences in average signals of left and right globus pallidus-average signals of ipsilateral frontal white matter among the four groups(P>0.05).Conclusion The diagnostic accuracy of MRI is high for brain injury in preterm infants with hyperbilirubinemia,which can provide a reliable basis for assessment of disease severity,with high application value.