Research On The Significance Of Globus Pallidus T1WI High Signal In The Diagnosis Of Actue Bilirubin Encephalopathy

Objective: To analyze characteristics of bilateral globus pallidus T1 WI signal on brain MRI in normal newborns,hyper-bilirubin ones and acute bilirubin encephalopathy ones,and to explore the significance of bilateral globus pallidus T1 WI signal intensity and abnormal signal area value in the diagnosis of acute bilirubin encephalopathy.Methods: a retrospective analysis on datum of 363 term neonates admitted into NO.1 hospital of Chenzhou children's hospital from January 1st,2015 to June 30 th,2016,who underwent brain MRI during the period of hospitalization.224 male neonates,139 female neonates,gestational age 37-41 weeks,the median gestational age 38 weeks,days of age 13 ± 9 days,the body weight of 2450± 1005 g.All the newborns were divided into three groups,control group,experimental group 1,experimental group 2.control group consisted of 61 cases normal newborns,experimental group 2 consited of 241 high blood bilirubin newborns,experimental group 2 consited of 61 acute bilirubin encephalopathy newborns.there were no obvious differences between the gender of three groups,neither were the gestational age or body weight.Firstly,two experienced doctors analyzed brain MRI of the three groups,who were blinded to all the newborns' clinical datum,determined if bilateral globus pallidus signal had increased by experience,and caculated pallidum T1 WI signal increasing rates of the three groups;Then analyzed the T1 WI images of the neonates with high T1 WI signal in bilateral globus pallidus,and measured the high signal area and high signal intensity.Cases with high T1 WI signal in bilateral globus pallidus of hyperbilirubin neonates were named experimental group 1 #,Cases with high T1 WI signal in bilateral globus pallidus acute encephalopathy neonates were named experiment al group 2#.Analyzed the MRI images of experimental group 1 # and experimental group 2#,measured pallidum T1 WI signal intesity and high signal scope and drawed the ROC curve of high signal scope to diagnose acute bilirubin encephalopathy,to find the best boundary value to diagnose acute bilirubin encephalopathy.Results: two experienced radiology doctors subjectively read all the brain MRI images(follow the principle of the blinded).there were 58/363 cases with bilateral globus pallidus T1 WI signal in all the neonates,of 1/61 case in control group,26/241 cases in experimental group 1,31/61 ones in experimental group 2.the increasing rates of globus pallidus T1 WI signal among the three groups were different;T2WI and DWI of all the neonates showed no abnormity.The globus pallidu average T1 WI signal value of the experimental group 1# was 711.5 ± 206.6,while the value of the experimental group 2# was 710.1 ±196.7.The globus pallidus high signal scope of the experimental group 1#was 47.6 ±8.2mm2,while the scope of the experimental group 2# was 57.5 ±5.5 mm2.There were no difference between The globus pallidu average T1 WI signal values of the experimental group 1# and the experimental group 2#(P > 0.05).There were statistical difference between The globus pallidu T1 WI high signal scope values of the experimental 1# and the experimental 2#(P > 0.05).measuring the globus pallidus T1 WI high signal intensity value for the diagnosis of acute bilirubin encephalopathy was of no significance,while measuring pallidum T1 WI high signal scpope value to the diagnosis of acute bilirubin encephalopathy was significant.The area under the ROC curve was greater than 0.7 in Pallidum T1 WI high signal area value in the diagnosis of acute bilirubin encephalopathy,implying measuring pallidum T1 WI high signal area value was important to the diagnosis of acute bilirubin encephalopathy.when pallidum T1 WI high signal area value was 49.25,Youden index is the highest in the diagnosis of acute bilirubin encephalopathy.Conclusions:Increased pallidum signal on cerebral MRI T1-weighted sequence was important for the diagnosis of acute bilirubin encephalopathy,and the measuring high signal scope of pallidum on T1-weighted sequence was more important than the signal intensity for the diagnosis of acute bilirubin encephalopathy.The pallidum high signal scope of 57.7±5.5mm2 on T1-weighted sequence implied Acute neonatal bilirubin encephalopathy,when the scope was 49.25,the diagnosis of acute bilirubin encephalopathy Youden index was the highest,the critical value can be used as the reference standard in the diagnosis of acute bilirubin encephalopathy.