Abstract: Objective　To investigate the characteristics and clinical diagnostic values of magnetic resonance imaging (MRI) and proton magnetic resonance spectrum (¹H-MRS) in neonatal bilirubin encephalopathy. Methods　Twenty-two neonates with bilirubin encephalopathy in Huadu District People's Hospital of Guangzhou from January 2016 to April 2020 were selected, and twenty normal full-term newborns were selected as control. Conventional MRI scan and ¹H-MRS of the bilateral globus pallidus were performed separately. Two associate chief doctors of the radiology evaluated the conventional MRI features. The ¹H-MRS data of the bilateral globus pallidus were obtained by PRESS sequence, and the values of N-aceytl aspartate (NAA), creatine (Cr), choline (Cho), NAA/Cr, NAA/Cho, and Cho/Cr were statistically analyzed between the two groups. Bivariate correlation analysis was conducted for the values of NAA, Cr, Cho, NAA/Cr, Cho/Cr, and NAA/Cho and total serum bilirubin (TSB) peak value among the 42 neonates. F-test, independent sample t-test, and Pearson correlation analysis were used. Results　The age of the bilirubin encephalopathy group was (7.4±2.6) days, and the gestational age was (37.89±2.1) weeks; the age of the control group was (9.2±4.8) days, and the gestational age was (38.6±1.9) weeks. In the bilirubin encephalopathy group, 18 cases (81.8%) had an abnormally high signal of T1 weighted imaging (T1WI) images in the bilateral globus pallidus and 12 cases (54.5%) had slightly increased signal in corresponding position in T2WI fluid attenuated inversion recovery (FLAIR) sequence. The values of NAA, NAA/Cho, and NAA/Cr of the bilateral globus pallidus MRS in the bilirubin encephalopathy group were significantly reduced compared with those in the control group, with statistically significant differences between two groups (all P<0.05). Conclusion　MRI combined with ¹H-MRS is an important auxiliary diagnostic method for neonatal bilirubin encephalopathy.

Key words: Bilirubin encephalopathy, MRI, Magnetic resonance spectrum, Neonates

摘要： 目的　探讨新生儿胆红素脑病的磁共振成像（MRI）和氢质子波谱特征以及其临床诊断价值。方法　收集2016年1月至2020年4月广州市花都区人民医院22例新生儿胆红素脑病患儿，对照组为正常足月新生儿共20例，分别进行常规MRI扫描和双侧苍白球氢质子磁共振波谱（¹H-MRS）分析。由2位放射科副主任医生阅片，评价两组新生儿的常规MRI图像特征。采用PRESS脉冲序列获得双侧苍白球的¹H-MRS数据，对两组新生儿乙酰天门冬氨酸（NAA）、肌酸（Cr）、胆碱（Cho）、NAA/Cr、NAA/Cho、Cho/Cr等值进行统计学分析，42例新生儿的MRS各项数值NAA、Cr、Cho、NAA/Cr、Cho/Cr、NAA/Cho比值与血清总胆红素（TSB）峰值分别进行双变量相关性分析。采用F检验、独立样本t检验、Pearson相关性分析。结果　胆红素脑病组日龄（7.4±2.6）d，胎龄（37.89±2.1）周；对照组日龄（9.2±4.8）d，胎龄（38.6±1.9）周。22例胆红素脑病患儿中，18例（81.8%）在双侧苍白球中出现T1加权成像（T1WI）图像异常高信号，12例（54.5%）相应部位T2加权成像液体衰减反转恢复序列（T2WI FLAIR）信号轻度增高。胆红素脑病组双侧苍白球MRS与对照组相比，NAA、NAA/Cho、NAA/Cr比值显著降低，两组间差异均有统计学意义（均P<0.05）。结论　MRI结合¹H-MRS是新生儿胆红素脑病的重要辅助诊断方法。

关键词: 胆红素脑病, MRI, 磁共振波谱, 新生儿