Application of magnetic resonance diffusion tensor imaging in bilirubin-induced neurological dysfunction in neonates

XU Jun, YANG Du-Jiao, HUANG Fu-Rong, ZHANG Ai-Min

Chinese Journal of Contemporary Pediatrics ›› 2020, Vol. 22 ›› Issue (7) : 711-715.

PDF(1394 KB)
PDF(1394 KB)
Chinese Journal of Contemporary Pediatrics ›› 2020, Vol. 22 ›› Issue (7) : 711-715. DOI: 10.7499/j.issn.1008-8830.2003139
CLINICAL RESEARCH

Application of magnetic resonance diffusion tensor imaging in bilirubin-induced neurological dysfunction in neonates

  • XU Jun, YANG Du-Jiao, HUANG Fu-Rong, ZHANG Ai-Min
Author information +
History +

Abstract

Objective To study the value of fractional anisotropy (FA) of regions of interest (ROI) on magnetic resonance diffusion tensor imaging (DTI) in bilirubin-induced neurological dysfunction in neonates. Methods A total of 91 neonates with hyperbilirubinemia who were hospitalized from January 2017 to January 2018 were enrolled. According to the peak level of total serum bilirubin, they were divided into three groups:mild/moderate increase (n=45), severe increase (n=35), and extremely severe increase (n=11). According to the presence or absence of abnormal neurological manifestations, they were divided into two groups:neurological dysfunction (n=20) and non-neurological dysfunction (n=71). Ten healthy full-term infants were enrolled as the control group. Head DTI was performed for all neonates to measure the FA values of the bilateral globus pallidus, the anterior limb of the internal capsule, the posterior limb of the internal capsule, and the cerebellar dentate nucleus. Results The extremely severe increase group had significantly lower FA values of the globus pallidus than the control, mild/moderate increase, and severe increase groups (P < 0.05). The severe increase group had significantly lower FA values of the globus pallidus than the control group (P < 0.05). The extremely severe increase group had significantly lower FA values of the posterior limb of the internal capsule than the control, mild/moderate increase, and severe increase groups (P < 0.05). The neurological dysfunction group had significantly lower FA values of the globus pallidus and the posterior limb of the internal capsule than the non-neurological dysfunction group (P < 0.05). Conclusions Serum bilirubin level combined with the changes in the DTI FA values of the globus pallidus and the posterior limb of the internal capsule can be used to predict the injury of cerebral nuclei and white matter fibers.

Key words

Hyperbilirubinemia / Diffusion tensor imaging / Fractional anisotropy / Neurological dysfunction / Neonate

Cite this article

Download Citations
XU Jun, YANG Du-Jiao, HUANG Fu-Rong, ZHANG Ai-Min. Application of magnetic resonance diffusion tensor imaging in bilirubin-induced neurological dysfunction in neonates[J]. Chinese Journal of Contemporary Pediatrics. 2020, 22(7): 711-715 https://doi.org/10.7499/j.issn.1008-8830.2003139

References

[1] Stevenson DK, Watchko JF, Maisels MJ, et al. Care of the Jaundiced Neonate[M]. Europe:McGraw-Hill Education, 2012:12-16.
[2] Bhutani VK, Wong R. Bilirubin-induced neurologic dysfunction (BIND)[J]. Semin Fetal Neonatal Med, 2015, 20(1):1.
[3] Thomalla G, Glauche V, Koch MA, et al. Diffusion tensor imaging detects early Wallerian degeneration of the pyramidal tract after ischemic stroke[J]. Neuroimage, 2004, 22(4):1767-1774.
[4] Baldoli C, Scola E, Della Rosa PA, et al. Maturation of preterm newborn brains:a fMRI-DTI study of auditory processing of linguistic stimuli and white matter development[J]. Brain Struct Funct, 2015, 220(6):3733-3751.
[5] 李冰肖, 柳国胜, 凌雪英, 等. MRI和DTI评价早产儿脑白质髓鞘发育[J]. 中国当代儿科杂志, 2016, 18(6):476-481.
[6] Yan R, Han D, Ren J, et al. Diagnostic value of conventional MRI combined with DTI for neonatal hyperbilirubinemia[J]. Pediatr Neonatol, 2018, 59(2):161-167.
[7] 肖斌, 谭长连. 基于小脑齿状核的新生儿高胆红素血症脑损伤的DTI研究[J]. 中国医师杂志, 2019, 21(7):989-992.
[8] Razek AAKA, Taman SE, El Regal ME, et al. Diffusion tensor imaging of microstructural changes in the gray and white matter in patients with Crigler-Najjar syndrome type I[J]. J Comput Assist Tomogr, 2020, 44(3):393-398.
[9] Wisnowski JL, Panigrahy A, Painter MJ, et al. Magnetic resonance imaging of bilirubin encephalopathy:current limitations and future promise[J]. Semin Perinatol, 2014, 38(7):422-428.
[10] Watchko JF. Kernicterus and the molecular mechanisms of bilirubin-induced CNS injury in newborns[J]. Neuromolecular Med, 2006, 8(4):513-529.
[11] 中华医学会儿科学分会新生儿学组, 《中华儿科杂志》编辑委员会. 新生儿高胆红素血症诊断和治疗专家共识[J]. 中华儿科杂志, 2014, 52(10):745-748.
[12] Bhutani VK, Johnson-Hamerman L. The clinical syndrome of bilirubin-induced neurologic dysfunction[J]. Semin Fetal Neonatal Med, 2015, 20(1):6-13.
[13] Johnson L, Brown AK, Bhutani VK. BIND-a clinical score for bilirubin induced neurologic dysfunction in newborns[J]. Pediatrics, 1999, 104:746-747.
[14] 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[J]. 中国CT和MRI杂志, 2019, 17(1):12-14.
[15] Groenendaal F, van der Grond J, de Vries LS. Cerebral metabolism in severe neonatal hyperbilirubinemia[J]. Pediatrics, 2004, 114(1):291-294.
[16] Brites D. The evolving landscape of neurotoxicity by unconjugated bilirubin:role of glial cells and inflammation[J]. Front Pharmacol, 2012, 3:88.
[17] Silva SL, Vaz AR, Barateiro A, et al. Features of bilirubin-induced reactive microglia:from phagocytosis to inflammation[J]. Neurobiol Dis, 2010, 40(3):663-675.
[18] Saksena S, Jain R, Narang J, et al. Predicting survival in glioblastomas using diffusion tensor imaging metrics[J]. J Magn Reson Imaging, 2010, 32(4):788-795.
[19] Fernandes A, Falcão AS, Silva RF, et al. MAPKs are key players in mediating cytokine release and cell death induced by unconjugated bilirubin in cultured rat cortical astrocytes[J]. Eur J Neurosci, 2007, 25(4):1058-1068.
[20] Cece H, Abuhandan M, Cakmak A, et al. Diffusion-weighted imaging of patients with neonatal bilirubin encephalopathy[J]. Jpn J Radiol, 2013, 31(3):179-185.
[21] Wisnowski JL, Panigrahy A, Painter MJ, et al. Magnetic resonance imaging abnormalities in advanced acute bilirubin encephalopathy highlight dentato-thalamo-cortical pathways[J]. J Pediatr, 2016, 174:260-263.
[22] 邓敏, 何四平, 伍光春, 等. 胆红素脑病所致听力受损患儿听觉通路纤维束的DTI研究:各向异性分数和其他扩散系数的变化[J]. 临床放射学杂志, 2017, 36(11):1679-1683.
[23] Okumura A, Hayakawa M, Tsuji T, et al. Diffusion tensor imaging in infants with basal ganglia-thalamic lesions[J]. Eur J Paediatr Neurol, 2008, 12(5):412-416.
[24] Boskabadi H, Zakerihamidi M, Moradi A, et al. Risk factors for sensorineural hearing loss in neonatal hyperbilirubinemia[J]. Iran J Otorhinolaryngol, 2018, 30(99):195-202.

PDF(1394 KB)

Accesses

Citation

Detail

Sections
Recommended

/