ABSTRACT
As a challenging complication of neonatal jaundice, bilirubin encephalopathy can be subdivided into acute and chronic isoforms with the latter also named kernicterus. Its mechanism remains unclear. Its main sequelaes lie in auditory deficiency and dyskinesis. Brain stem auditory evoked potentials test is highly valued in the early diagnosis of kernicterus and the screening of auditory deficiency. MRI manifests symmetrical Tl-weighted signals on pallidum in acute phase and T2-weighted signals in chronic phase. The practical value of magnetic resonance spectrum yet demands further exploration.
ABSTRACT
Objeetive To explore routine magnetic resonance imaging characteristics of newborn bilirubin encephalopathy(NBE).Methods MRI features and clinical data of 17 patients with Newbern bilirubin encephalopathy were retrospectively analyzed, globus pallidus (GP)and subthalamic signal intensity was evaluated.The increase of GP signal intensity and serum total bilirubin peak value were analyzed using pearson correlation analysis.Serum total bilimbin peak value between patients with high signal in the subthalamic nuclei on T1 WI and patients without high signal in the subthalamic nuclei were compared statistically.Results The main MRI presentation in the NBE group Was abnormally increased signal intensity in the GP on T1 WI,which was not apparent on T2 WI One patient showed abnormal high signal intensity in the postemmedial part of GP.Nine patients had high signal in the subthalamic nuclei on T1 WI and normal signal on T2 WI Four patients showed hiigh signal in the brainstem with sparing of dorsal pontine.The increase in value of GP signal intensity was 249.0-423.8 in 12 patients and their serum total bilirubin peak values were 366.0-983.3μmol/L A positive correlation Was found between increase of GP signal intensity and serum total bilirubin peak value.The serum total bilirubin level of abnormal subthalamic group and normal subthalamic group were 660.7±192.4 μmol/L and 513.3±107.5μmol/L respectively.The difference between the two groups was not statistically significant(t=1.914,P＞0.05).Conclusion The routine MRI has some characteristics and is useful in the diagnosis of newborn bilirubin encephalopathy.