磁敏感加权成像在新生儿高胆红素血症颅内出血的应用研究

doi:10.12117/jccmi.2018.11.002

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Abstract Objective: To explore the value and limitation of SWI compared with conventional MRI in intracranial hemorrhage patients with neonatal hyperbilirubinemia. Materials and Methods: We conducted a study including 120 neonates. All 120 neonatal cases received MRI and SWI scanning, two radiologists who don’t know the history of subjects analyzed MRI and SWI images by double blind method. We recorded the detection of hemorrhagic cases and numbers in routine MRI and SWI and analyzed the performances of the intracranial hemorrhage in different locations. Results: ①The detection rates of neonatal intracranial hemorrhage between MRI and SWI were statistically significant(P<0.001), SWI is superior to conventional MRI. In the high blood bilirubin group, the detection positive rates of bleeding in routine MRI and SWI were statistically significant(P<0.05), and in the normal control group, the detection positive rate of bleeding in routine MRI and SWI were not statistically significant(P>0.05).②Among 120 neonates there were 43 cases with intraeranial hemorrhage detected on routine MRI sequences and/or SWI. Among neonates with intraeranial hemorrhage there were 27 preterm and 16 term neonates; 29 neonates with high bilirubin and 14 cases of normal control. The differences of incidences between preterm infants and full term were statistically significant(P<0.05). Incidences of neonatal intracranial hemorrhage between high blood bilirubin group and normal control group were compared, differences were significant(P<0.05). ③Among 43 neonates with intracranial hemorrhage, there were only 14 cases showed extracerebral hemorrhage(8 cases subarachnoid hemorrhage(SAH), 5 cases subdural hemorrhage(SDH), 1 SDH combined with cerebral hemorrhage). All 14 cases were found in both MRI and SWI. The detection positive rates of extracerebral hemorrhage between MRI and SWI were not statistically significant(P>0.05). ④Twenty-nine cases were detected with intracerebral hemorrhage on SWI, and among them 10 cases did not be detected on conventional MRI sequences. Neonatal intracerebral hemorrhage included subependymal hemorrhage/intraventricular hemorrhage(PVH-IVH), intraparenchymal hemorrhage(IPH) and cerebellar hemorrhage(CH). The detection positive rates of PVH-IVH between conventional MRI and SWI did not show obvious statistical significance(P>0.05). The parenchymal hemorrhage(including IPH and CH) always showed the form of microbleeds(foci<10 mm), the detection positive rates of SWI were superior to conventional MRI, the differences were considered as statistically significant(P<0.05). ⑤Among 43 cases with intracranial hemorrhage 122 foci were detected, including 19(15.2%) PVH-IVH, 43(35.2%) IPH, 46(37.7%) CH, 6(4.9%) SDH and 8(6.8%) SAH on SWI. On conventional MRI 78 foci were detected. The comparison was statistically significant(P<0.05). ⑥In our study, the PVH-IVH was detected more among premature than full term infants. The IPH and CH were detected among preterm and full term infants. The SDH was detected more among full term infants and SAH was detected more among premature infants. Conclusion: The incidence of intracranial hemorrhage in premature infants with high blood bilirubin level is higher than normal control infants. SWI is superior to conventional MRI in the detection positive rates and focus numbers of parenchymal hemorrhage and can be used as a powerful supplement to conventional MRI.

Key words： Jaundice, neonatal Intracranial, hemorrhage Magnetic resonance imaging

Received: 19 December 2017

PACS:	Ｒ651.15
	R722.17
	Ｒ445.2

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	Articles by authors
	GUO Li-li1
	WANG De-hang2
	ZHANG Hui1
	TAO Wei-jing1
	BO Gen-ji1

Cite this article:

GUO Li-li1,WANG De-hang2,ZHANG Hui1, et al. The application of MR SWI in intracranial hemorrhage of neonatal hyperbilirubinemia[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(11): 764-770.

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http://www.jccmi.com.cn/EN/10.12117/jccmi.2018.11.002 OR http://www.jccmi.com.cn/EN/Y2018/V29/I11/764

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