Preliminary Study Of MRI And ~1H-MRS In Diagnosis Of Acute Bilirubin Encephalopathy

Preface and PurposeAcute Bilirubin encephalopathy(ABE)is a symptom complex of nervous system caused by severe hyperbilirubineamia during the neonatal period.MRI reconstructs imaging with signal which is produced by atomic nucleus resonancing in magnetic field,and MRS measures compound signal by chemical shift effect.They are non-invasive technique which can monitor the metabolism of the brain,physiological and biochemical change in ABE.The aim of this study was to investigate the related characterized imaging in normal MRI and get information about the metabolites in basal ganglia of ABE.The research can offer another method for studying mechanism and evaluating the prognosis of ABEMaterials and Methods28 cases with the clinical proved ABE were selected to perform MRI and ~1H-MRS inspection.At the same time we choose 15 normal neonatals as a control group of research.All examinations were performed on philips3.0T superconducting magnetic resonance scanning system.Spin-echo(SE)sequence were used in conventional MRI scanning,and ~1H-MRS used point resolved spectroscopy(PRESS)(TR 2000/200 ms, TE 288/30 ms).Mapping of the main Metabolites including N-aspartate(NAA), creatine complex(Cr),choline complex(Cho),inositol(mI),lactate(Lac), glutamate and glutamyl by the software package of the machine itself.The concentration of metabolites was ompared between the two groups.ResultConventional magnetic resonance imaging showed high signal of T1-WI in globus pallidus of ABE patients.The case group and the control group were significantly different.MRS revealed that the relative concentrations of mI/Cr and Glx/Cr has significant difference between two groups(P＜0.01),and Cho/Cr,NAA/Cr and Lac/Cr has no significant difference.According to the total bilirubin(TB)level,the case group was divided into three group,that is TB＜25mg/dl,25mg/dl＜TB＜30mg/dl and TB＞30mg/dl.Total bilirubin level and the concentration of metabolites in the brain has not obvious correlation.ConclusionABE has a characteristic signature that is detectable on MRI and 1H-MR spectroscopy.Our results are generally in agreement with what is known about bilimbin pathology.Symmetrical high T1 signal in Globus pallidus area of neonatal acute bilirubin encephalopathy is one of characteristic MR imaging.The finding of increased glutamate and glutamine and mI ratios may help in elucidating the pathophysiology of bilirubin neurotoxicity.