静息态功能磁共振在新生儿急性胆红素脑病中的应用

目的 急性胆红素脑病是影响新生儿生存质量的重要因素，早期症状不显著，故临床诊断难度较大，本文探讨静息态功能磁共振成像在新生儿胆红素脑病中的应用价值。 方法 选择杭州师范大学附属医院2015年12月—2017年12月期间住院诊断为急性胆红素脑病的患儿15例及正常足月儿14例。对2组新生儿进行静息态磁共振成像检查，用MATLAB、SPM及DPARSF软件对图像进行处理，最后采用低频振幅方法进行对比其脑功能变化，获得2组ALFF值的差异性脑区。 结果 急性胆红素脑病患儿与正常足月儿相比:低频振幅峰值强度颞叶为6.85、中央前回为5.02、额极的脑区为3.34，有异常增高，差异均有统计学意义(均P＜0.05)；而枕叶ALFF峰值强度为-3.36及顶叶为-3.60、左侧小脑为-4.42及右侧小脑为-3.12，与正常对照组比较相应的脑区ALFF强度峰值减低，差异均有统计学意义(均P＜0.05)。 结论 与正常的新生儿相比，胆红素脑病患儿在颞叶、中央前回、额极、枕叶、顶叶、小脑等脑区有异常脑功能改变，与胆红素脑病患儿的临床表型在大脑中的定位可能有一定的相关性。静息态功能磁共振成像对新生儿胆红素脑病早期诊断有重要价值。 

The application of resting state functional magnetic resonance in neonatal acute bilirubin encephalopathy

Objective Acute bilirubin encephalopathy (ABE) is an important factor affecting the quality of life of newborns. Early symptoms are not significant, so clinical diagnosis is difficult. This paper discusses the application value of resting-state functional magnetic resonance imaging in neonatal bilirubin encephalopathy. Methods Fifteen children with acute bilirubin encephalopathy and 14 full-term normal infants were selected from the Affiliated Hospital of Hangzhou Normal University from December 2015 to December 2017. Two groups of newborns were examined by resting MR imaging. The images were processed by MATLAB, SPM and DPARSF software. At last, the changes of brain function were compared by low frequency amplitude method, differential brain regions of ALFF values were obtained in two groups. Results Compared with normal full-term infants, acute bilirubin encephalopathy children showed abnormal increase in peak intensity of low-frequency amplitude in temporal lobe, anterior central gyrus and frontal pole (all P<0.05), and significant difference in peak intensity of ALFF in occipital lobe, parietal lobe, left cerebellum and right cerebellum, which were 6.85, 5.02 and 3.34 respectively, compared with normal control group. The peak value of ALFF intensity decreased (all P<0.05), and the difference was statistically significant. Conclusion Compared with normal newborns, bilirubin encephalopathy children have abnormal brain function changes in temporal lobe, anterior central gyrus, frontal pole, occipital lobe, parietal lobe and cerebellum, which may be related to the location of clinical phenotypes in the brain of bilirubin encephalopathy children. Resting-state functional magnetic resonance imaging has important value in early diagnosis of neonatal bilirubin encephalopathy.