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苍白球与壳核T1WI信号比值在足月儿急性高胆红素相关脑病的临床研究

Relationship between high bilirubin related encephalopathy and T1WI signal intensity ratio of globus pallidus to putamen in term neonates
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摘要 目的研究双侧苍白球与壳核T1WI信号比值(G/P)在足月儿高胆红素相关脑病诊断中的价值。方法回顾性分析105例新生儿的头颅MRI信号特征和临床资料,其中86例非高危因素足月儿分别根据血清总胆红素(TSB)分为Ⅰ~Ⅳ组,根据临床症状分为A~C组;测量双侧苍白球及壳核T1WI信号强度并计算其G/P值;通过t检验、单因素方差分析进行各组数据比较;通过ROC曲线分析G/P值来预测病情进展情况。结果(1)①按TSB分组,ⅠvsⅡ、ⅠvsⅢ、ⅠvsⅣ、ⅡvsⅢ、ⅡvsⅣ组间比较,各组间存在差异(P<0.05)。ⅢvsⅣ组差异无统计学意义(P>0.05)。②按临床症状分组,各组间存在差异(P<0.05)。(2)利用G/P值的ROC曲线来评估:①预测高胆红素血症危险程度,最佳临界点分别为1.51、1.62。②评估出现急性胆红素脑病(ABE)的ROC曲线,最佳临界点分别为1.70、1.69。结论苍白球及壳核T1WI信号比值(G/P)对诊断早期ABE有一定的价值,其结合临床表现,可进行全面辨证分析,从而增大诊断的客观准确性。 Objective To determine the value of T1WI signal ratio of bilateral globus pallidus to putamen in diagnosis of high bilirubin related encephalopathy of term neonates. Methods The cranial MRI signal characteristics and clinical data of 105 newboms were analyzed retrospectively. According to the total serum bilirubin ( TSB) and clinical symptoms, 86 cases without risk factors of term neonates were divided into 4 groups (Ⅰ~Ⅳ and 3 groups (A~C).The T1WI signal inten sity of bilateral globus pallidus and putamen were measured and the ratio of G/P was calculated.The data of each group were compared and analyzed by t test and A NOVA .ROC curve of G/P ratio was performed to predict the progress of disease.Results There was statistically significant difference between group Ⅰ and group Ⅱ, group Ⅰ and group Ⅲ, group Ⅰ and group Ⅳ, group Ⅱ and group Ⅲ,group Ⅱ and group Ⅳ( P<0.05 ), whereas no difference was found between group DI and group Ⅳ(P>0.05).Comparing the three groups divided by clinical symptoms, statistically significant differences were observed (P<0.05).The ROC curve revealed that for serum TSB, the predictive risk of hyperbilirubinemia with 1.51 and 1.62 , the predictive performance for high bilirubin related encephalopathy with 1.70 and 1.69.Conclusion The T1WI signal intensity ratio of G/P potentially assists in the diagnosis of high bilirubin related encephalopathy.Combined with clinical manifestations, it can be comprehensively analyzed dialectically, thereby increasing the objective accuracy of diagnosis.
作者 尹家瑜 申炜 许梅海 卢平明 韦洁勤 YIN Jiayu;SHEN Wei;XU Meihai;LU Pingming;WEI Jieqin(MRI Room,the First People's Hospital of Nanning,Nanning 530022,China)
出处 《实用放射学杂志》 CAS 北大核心 2019年第3期433-436,共4页 Journal of Practical Radiology
基金 南宁市重点研发项目(20173237)。
关键词 胆红素 苍白球 T1WI信号比值 磁共振成像 足月儿 bilirubin globus pallidus T1 weighted imaging magnetic resonance imaging term neonate
作者简介 尹家瑜(1984-),女,上海市人,硕士,主治医师,研究方向:中枢神经系统影像诊断;通信作者:申炜,E-mail: shenwei639@qq.com.
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