Diagnosis of neonatal bilirubin encephalopathy based on quantitative analysis of multiparameter magnetic resonance imaging

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• Clinical Article •

TAN Weiting LUO Yi SUN Weisheng ZHUANG Yijiang ZHANG Shaojun ZHAO Yilin ZENG Hongwu

Cite this article as: TAN W T, LUO Y, SUN W S, et al. Diagnosis of neonatal bilirubin encephalopathy based on quantitative analysis of multiparameter magnetic resonance imaging[J]. Chin J Magn Reson Imaging, 2023, 14(2): 27-32. DOI:10.12015/issn.1674-8034.2023.02.005.

Abstract

[Abstract] Objective To explore the value and optimal parameters of quantitative analysis of globus pallidus (GP), putamen(P) and thalamus (T) signal intensity on T1WI, T2WI, and apparent diffusion coefficient (ADC) images for the early diagnosis of neonatal bilirubin encephalopathy (NBE).Materials and Methods We collected the clinical and imaging data of full-term NBE children from January 2018 to July 2022 in Shenzhen Children's Hospital, and age- and gender-matched normal neonates were selected as controls. The software measureed the signal intensity of GP, P and T. Two independent samples t test was used to compare and analyze the signal intensity of GP, T, the ratio of GP to P on T1WI, T2WI, ADC (GP/P¹, GP/P², GP/P^A) and the ratio of T to P on T1WI, T2WI, ADC (T/P¹, T/P², T/P^A); We analyzed the receiver operating characteristic (ROC) curve to find the optimal MRI parameters for the diagnosis of NBE. According to the scores of bilirubin induced neurological dysfunction, children with NBE were divided into three groups: mild, moderate and severe, one-way analysis of variance was used to compare and analyze the differences among the three groups of NBE children.Results There were 60 children with NBE, 22 were mild, 24 were moderate, 14 were severe, and 31 were in the normal control group. The results of two independent samples t test showed that: in T1WI images, the GP and T signal intensity and ratios (GP/P¹, T/P¹) were higher than those in the normal control group, and the differences were statistically significant (P＜0.010); in T2WI and ADC images, GP, T signal intensity and ratios (GP/P², T/P², GP/P^A, T/P^A) were not significantly different (P＞0.05). The ROC curve analysis showed that the area under the curve (AUC) of GP and T signal intensity in T1WI images were 0.785, 0.870, respectively, and the optimal critical threshold was 267.83 and 295.17, respectively; the AUC of G/P¹ and T/P¹ in T1WI images was 0.794 and 0.756, and the optimal critical threshold was 1.41, 1.13, respectively. One-way analysis of variance showed that the higher the clinical severity of NBE, the higher the GP and T signal intensity in T1WI images, and the higher the GP/P¹ and T/P¹ ratios.Conclusions Quantitative analysis of magnetic resonance signal intensity based on T1WI images can diagnose NBE early and objectively. The signal intensity of GP and T and the ratio of GP/P¹ and T/P¹ on T1WI images can be the optimal MRI parameters to diagnose NBE early and accurately and grade the severity of NBE dynamically. Also, above parameters provide objective imaging evidence for clinical diagnosis and treatment of NBE.

[Keywords] neonatal；bilirubin encephalopathy；magnetic resonance imaging；early diagnosis；severity grading

Contributor Information

TAN Weiting^{1,
2}   LUO Yi^{1,
3}   SUN Weisheng^{1,
3}   ZHUANG Yijiang¹   ZHANG Shaojun^{1,
3}   ZHAO Yilin^{1,
2}   ZENG Hongwu^1*

¹ Department of Radiology, Shenzhen Children's Hospital, Shenzhen 518038, China

² Department of Radiology, Shenzhen Children's Hospital of China Medical University, Shenzhen 518038, China

³ Shantou University Medical College, Shantou 515041, China

*Correspondence to: Zeng HW, E-mail: homerzeng@126.com

Conflicts of interest None.

Publication Information

ACKNOWLEDGMENTS Natural Science Foundation of Guangdong Province (No. 2022A1515011427); "Sanming Project" of Medicine in Shenzhen (No. SZSM202011005).

Received 2022-09-26

Accepted 2023-01-12

DOI: 10.12015/issn.1674-8034.2023.02.005

Text

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