The Semi-Quantitative Analysis Of Brain Magnetic Resonance Imaging In The76Cases Of Neonatal Indirect Hyperbilirubinemia

Objective To investigate the feasibility of interpretation on the brain magnetic resonance imaging (MRI) semi-quantitatively, and the specific brain MRI changes in those neonate infants, We analyzed the signal intensity of brain MRI with the semi-quantitative imaging analysis method in the newborn infants35or more weeks of gestation (GA≥35weeks) with indirect hyperbilirubinemia.Method Seventy-six of neonatal infants with GA>35weeks who were diagnosed with neonatal indirect hyperbilirubinemia or bilirubin encephalopathy and admitted in the Second XiangYa Hospital of Central South University between Oct,2009to Oct,2013. The infants were assigned into group A[total serum bilirubin (TSB)<221μmol/L)], group B (221μmol/1≤TSB<342μmol/L), group C (342μmol/1≤TSB<428μmol/L) and group D (TSB≥428μmol/L) depending on peak TSB. We selected the region of interesting (ROI) in the brain MRI, including globus pallidus (GP), the white matter around the anterior horn of lateral ventricule (AHLV) and posterior horn of lateral ventricule (PHLV), and then used the Image-pro plus6.0software to calculate the ratio of the average optical density (AOD) in the ROI to the AOD in the cerebrospinal fluid, named as the relative optical density (ROD).Result In brain MRI T1weighted images (T1WI), the RODs in GP were significantly lower in group D than those in the other groups (P<0.001).The TSB and the ratio of TSB to serum albumin concentration (B/A) had significantly negative correlation with the ROD in the GP (P<0.05). The corrected age had significantly negative correlation with the RODs in the white matter around AHLV and PHLV (P<0.05). Compared to those with acute bilirubin encephalopathy, the RODs in the ROIs of brain MRI T1WI were similar in the neonatal infants without bilirubin encephalopathy(P>0.05). There exists significantly negative correlation between the TSB and neonatal behavioral ability (P<0.05), but there no significance correlation between the RODs in ROI and neonatal behavioral neurological assessment (P>0.05). According to the RODs in the ROIs of brain MRI TI WI, the patients assigned into lower quartile group[RODs less than the25th percentile (P≤25)], middle quartile group [RODs between the25th percentile and the75th percentile(P25～P75)] and upper quartile group[RODs more than the75th percentile (P≥25)],there is no significance different among the pass ratio of otoacoustic emissions (OAE) and the three groups, respectively (P>0.05)Conclusion1. Semi-quantitative analysis can be a possible method to assess the traditional brain magnetic resonance imaging of neonatal indirect hyperbilirubinemia.2. The signal intensity of GP in brain MRI T1weighted image has a significance correlation with TSB and B/A.