DWI and 3D SWAN improve the knowledge of pathophysiological mechanism of neonatal bilirubin encephalopathy

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• Clinical Article •

YU Jinhong WANG Jingshi MIAO Yanwei LIU Yiyong SUN Fei

Cite this article as: Yu JH, Wang JS, Miao YW, et al. DWI and 3D SWAN improve the knowledge of pathophysiological mechanism of neonatal bilirubin encephalopathy. Chin J Magn Reson Imaging, 2020, 11(11): 994-998. DOI:10.12015/issn.1674-8034.2020.11.008.

Abstract

[Abstract] Objective: To investigate the possible pathophysiological mechanism of hyperbilirubinemia (HB) on neonatal brain tissue injury by analyzing the diffusion-weighted imaging (DWI) and susceptibility weighted imaging (SWI) manifestations of bilirubin encephalopathy in full-term neonates.Materials and Methods: The DWI and (three dimensions T2^* weighted angiography (3D SWAN) data of 75 neonates with HB clinically confirmed were analyzed retrospectively. Children with HB were divided into two groups according to the T1WI signal of globus pallidus: normal signal (HBn group, 46 cases) and high-intensity signal group (HBh group, 29 cases). While 44 cases of healthy neonates were collected as the healthy control group (HC group). The ADC values were measured, and the ADC ratios (rADC value) were calculated in bilateral GPs and frontal white matter (FWM), and the number of low-signal foci (microbleeds) of 3D-SWAN were counted. The differences of MRI parameters between groups and their correlation with total serum bilirubin (TSB) were analyzed.Results: The rADC value of GP in HC group, HBn group and HBh group decreased successively (P<0.05), while the difference between HC and HBh groups was significant (P<0.05). Compared with HC group, the number of intrcerebral microbleeds (CMBs) in HB group was significantly increased (P<0.05). The rADC value of HB group had a positive correlation with TSB (r=0.202, P=0.013). However, no correlation was found between the number of CMBs in HB group and TSB (P=0.278).Conclusions: The limited diffusion of water molecules is present in GP and related to the level of total bilirubin in children with HB. CMBs more likely occur in children with HB and need to attach importance to it during treatment.

[Keywords] bilirubin encephalopathy；neonates；diffusion weighted imaging；suseeptibility weighted imaging

Contributor Information

YU Jinhong Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; Department of Radiology, Dalian Women and Children's Medical center, Liaoning Province, Dalian 116033, China

WANG Jingshi Department of Radiology, Dalian Women and Children's Medical center, Liaoning Province, Dalian 116033, China

MIAO Yanwei^* Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

LIU Yiyong Department of Radiology, Dalian Women and Children's Medical center, Liaoning Province, Dalian 116033, China

SUN Fei Department of Radiology, Dalian Women and Children's Medical center, Liaoning Province, Dalian 116033, China

*Correspondence to: Miao YW, E-mail: ywmiao716@163.com

Conflicts of interest None.

Publication Information

Received 2020-05-12

Accepted 2020-09-16

DOI: 10.12015/issn.1674-8034.2020.11.008

Text

References

[1]

Bahr TM, Christensen RD, Agarwal AM, et al. The neonatal acute bilirubin encephalopathy registry (NABER): background, aims, and protocol. Neonatology, 2019, 115(3): 242-246. DOI: 10.1159/000495518

[2]

闫瑞芳，韩东明，任继鹏，等．常规MRI联合DTI对新生儿高胆红素血症的诊断价值．儿科和新生儿学, 2018, 59(2): 61-167. DOI: 10.1016/j.pedneo.2017.07.009

[3]

Niwa T, Aida N, Shishikura A, et al. Susceptibility-weighted imaging findings of cortical laminar necrosis in pediatric patients. AJNR Am J Neuroradiol, 2008, 29(9):1795-1798. DOI: 10.3174/ajnr.A1184

[4]

尹家瑜，申炜，许梅海，等．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．实用放射学杂志, 2019, 35(3): 433-436. DOI: 10.3969/j.issn.1002-1671.2019.03.024

[5]

仪晓立，王晓颖，袁新宇，等．苍白球T1值诊断急性胆红素脑病.中国医学影像技术, 2014, 30(5): 645-648. DOI: 10.13929/j.1003-3289.2014.05.001

[6]

孟小丽，张雷，王晓虎，等．新生儿重度高胆红素血症的MRI信号特征分析．磁共振成像, 2018, 9(10): 768-772. DOI: 10.12015/issn.1674-8034.2018.10.010

[7]

荆彦平，强孔俊，骆宾，等．急、慢性胆红素脑病MRI特征及预后．实用放射学杂志, 2018, 34(7): 1087-1089. DOI: 10.3969/j.issn.1002-1671.2018.07.027

[8]

李俊，李雅丽，高敏，等．新生儿胆红素脑病磁共振波谱成像在苍白球的特征分析.临床放射杂志, 2018, 37(6): 1025-1029. DOI: 10.13437/j.cnki.jcr.2018.06.036

[9]

易明岗，姜忠强，赵建设，等．苍白球与壳核T1WI信号强度比值在新生儿急性胆红素脑病分级及预后中的价值．中华放射学杂志, 2017, 51(3): 214-218. DOI: 10.3760/cma.j.issn.1005?1201.2017.03.013

[10]

靳金岩，李洪义. MRI及功能成像改变对新生儿高胆红素脑病临床价值分析．中国CT和MRI杂志, 2019, 17(1): 12-14, 24. DOI: 10.3969/j.issn.1672-5131.2019.01.004

[11]

吴武林，张平，娄明武，等. DWI及常规MR在新生儿高胆红素血症及胆红素脑病诊断中的应用．实用放射学杂志, 2011, 27(8): 1242-1244,1248. DOI: 10.3969/j.issn.1002-1671.2011.08.033

[12]

符式新，张凯钟，柏燕．胆红素脑病患儿的MRI、MRS的影像特点及其临床转归．中国CT和MRI杂志, 2018, 16(3): 11-13. DOI: 10.3969/j.issn.1672-5131.2019.01.004

[13]

Cece H, Abuhandan M, Cakmak A, et al. Diffusion-weighted imaging of patients with neonatal bilirubin encephalopathy. Jpn J Radiol, 2013, 31(3): 179-185. DOI: 10.1007/s11604-012-0166-4

[14]

Watchko JF. Kernicterus and the molecular mechanisms of bilirubin-induced CNS injury in newborns. Neuromolecular Med, 2006, 8(4): 513-529. DOI: 10.1385/NMM:8:4:513

[15]

Falcao AS, Silva RF, Fernandes A, et al. Influence of hypoxia and ischemia preconditioning on bilirubin damage to astrocytes. Brain Res, 2007, 1149: 191-199. DOI: 10.1016/j.brainres.2007.02.039

[16]

Watchko J F, Maisels M J. The enigma of low bilirubin kernicterus in premature infants: why does it still occur, and is it p3reventable? Semin Perinatol, 2014, 38(7): 397-406. DOI: 10.1053/j.semperi.2014.08.002

[17]

吕峻峰，杨冰岩，王维琼，等．严重高胆红素血症新生儿急性胆红素脑病危险因素分析．中国新生儿科杂志, 2014, 29(4): 242-246. DOI: 10.3969/j.issn.1673-6710.2014.04.007

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