高级检索

    高胆红素血症患儿早期头颅影像学异常的门诊随访研究

    A follow-up visit study of hyperbilirubinemia outpatients with early abnormality in brain MRI and/or 1H-MRS images

    • 摘要: 目的通过对早期头颅MRI和(或)氢质子磁共振频谱(1H-MRS)诊断异常的高胆红素血症患儿进行门诊随访,评估头颅MRI和1H-MRS在高胆红素血症临床诊断中的价值。方法100例高胆红素血症患儿行头颅MRI和或1H-MRS检查,结果异常。给予必要的临床干预后出院,并按时门诊随访。随访内容包括临床神经检查、头颅MRI和或1H-MRS等。月龄小于6个月者,每月随访1次,月龄大于或等于6个月以上者,每2个月随访1次,随访到1岁。结果7日龄时单项MRI、单项1H-MRS、MRI和1H-MRS均异常的胆红素脑损伤诊断率分别是57.0%、75.0%和25.0%,显著高于临床胆红素脑损伤诊断率12.0%(P<0.05)。3月龄时单项MRI、单项1H-MRS的胆红素脑损伤诊断率均为39.2%,显著高于临床胆红素脑损伤诊断率21.6%(P<0.05)。1岁时,各指标对胆红素脑损伤的诊断率相比,差异无统计学意义(P>0.05)。结论早期头颅MRI或1H-MRS对胆红素脑损伤的诊断较敏感,动态随访患儿MRI检查比单次检查更有临床意义。

       

      Abstract: ObjectiveTo evaluate the application of cranial MRI and/or 1H-MRS in diagnosing child outpatients with hyperbilirubinemia through follow-up visits. MethodsA total of 100 hyperbilirubinemia child patients underwent cranial MRI and/or 1H-MRS and abnormal changes were detected. After necessary clinical intervention, they were discharged and follow-up visited regularly. The visits included clinical neurological examination, MRI and/or 1H-MRS. The required follow-up frequency was once per month for less than six-month-old child patients, once other month for those more than six-month-old, until one-year-old. ResultsThe diagnostic rate of bilirubin brain injury was 57.0% by MRI, 75.0% by 1H-MRS and 25.0% by both at 7-day-old, which were remarkably higher than 12.0% by clinical bilirubin detection (P<0.05). The diagnostic rate of bilirubin brain injury was 39.2% by MRI and 21.6% by 1H-MRS at 3-month-old, which were remarkably higher than 21.6% by clinical bilirubin detection (P<0.05). However, there was no statistical difference in the diagnostic rate of bilirubin brain injury among these indexes at 1-year-old (P>0.05). ConclusionsEarly cranial MRI or 1H-MRS is sensitive to diagnose bilirubin brain injury. Dynamic imaging examination in follow-up visits is more clinical useful than single examination.

       

    /

    返回文章
    返回