| Background Neonatal jaundice is the most common physiological and pathological phenomena of the clinical, most of the neonatal jaundice are mild, but about25in100thousents neonatal can occur serious high blood bilirubin which cause acute bilirubin encephalopathy or nuclear jaundice.Bilirubin encephalopathy always lead varying degrees of neurological sequelae that seriously affect the neonatal survival rate and life quality.In1904, Sehmorl held an autopsy on the remains of one neonate died of severe jaundice and found that the brain basic nuelear was yellow-dyed and named this disease as kernicterus.This yellow-dyed material is identified as unconjugated bilirubin, it can cause toxic disease of neuro-cells,so kenicterus is also called bilirubin encepha-loPathy.Bilinlbin encephalopathy is the important complication of neonate pathologic jaundice, but is not the ouly one.Bilirubin neurotoxicity have dose-dependent and time-dependent.Nowadays,there isn’t a generally accepted and objeetive clinical deternination for kernicterus,it can only diagnosed according to clinilcal haracteristics and lab examinations.Shapiro thought although total serum bilirubin (TSB) is important,kernicters can be defined based on TSB≧342μ mol/L,abnormal of muscle tone on examination,brain-stem auditory evoked potential,magnetic resonanee imaging showing bilateral lesions of globus pallidus subthalamic nucleus.But the application of clinical symptoms to determine bilirubin encephalopathy far from accurate.Objective The purpose of this article,is to investigate the diagnostic value and clinical significance for MRI for ABE to provide an objeetive basic for diagnosis and prognosis of ABE. Methods1. eighty-five neonates with ABE received cranial MR1examination using Philips Achieva1.5T MRI seanner with NV16coil,and they were divided into three groups depending on the the level of clinical diagnosis.2. MR Pulses sequence include transverse T1WI(SE sequence),T2WI(TSE sequence),DWI(EPI/SE sequence).3. Two-way Analysis of variance was used to analyse the signal intensity of T1WI and T2WI,the value of eADC and ADC in both globus-pallidus.And then,compare the difference between the results and the results according to the naked eyes.4. Statistical treatment:All data is used SDNNI (x±S) to expression,and SPSS13.0to design analysis of variance.The data is statistically significant when the P<0.05of the analysis of variance.Results1. There are nine neonate’s T1WI signal intensity in both globus-pallidus in group III is higher and the Ⅱ group’s(12/19),however,there are also neonates whose globus-pallidus manifested obvious high signal in the Ⅰ group’s (34/56).There are five neonate’s T2WI signal intensity is higher in the three groups.2. The value of T1WI signal intensity in grope Ⅲ is significantly higher than grope Ⅰ and II,the difference has statistical significance (p<0.05). There is no obvious difference beteween grope Ⅰ and Ⅱ (p>0.05).There is no difference between the left and right globus-pallidus T1WI signal intensity in three gropes (p>0.05).Moreover the signal intensity of the neonates whose globus-pallidus looks obvious high signal in T1WI of grope Ⅰ and Ⅱ is lower than the mean value of group Ⅲ.There is no statistical difference among the three gropes about the signal intensity of T2WI (P>0.05).3. The G/P values of mild group and moderate group and severe group are gradually increased, and the difference was statistically significant(P<0.05).The difference of poor prognosis group and good prognosis group’s G/P value have statistically significant(P<0.05). Conclusion1. There is an intimate relationship between the G/P in both globus-pallidus on T1WI and the severity of degree of ABE’s condition. The heavier group G/P value is higher.2. G/P can prompt globus pallidus damage, When G/P value is greater than1.33, can prompt globus pallidus damage is serious, children often poor prognosis. |
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