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Published in: Neuroradiology 10/2008

01-10-2008 | Paediatric Neuroradiology

Studying neonatal bilirubin encephalopathy with conventional MRI, MRS, and DWI

Authors: Xiaoyi Wang, Wulin Wu, Bob L. Hou, Ping Zhang, Ashley Chineah, Fan Liu, Weihua Liao

Published in: Neuroradiology | Issue 10/2008

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Abstract

Introduction

The purpose of this study was to evaluate the diagnostic value of conventional magnetic resonance imaging (MRI), proton magnetic resonance spectroscopy (1H-MRS), and diffusion-weighted imaging (DWI) for neonatal bilirubin encephalopathy.

Methods

We collected conventional MRI in 24 neonates with neonatal bilirubin encephalopathy. We performed 1H-MRS and DWI sequences to nine of the 24 patients and seven age-matched healthy control subjects. Multiple-voxel 1H-MRS data were acquired using PRESS pulse sequence with TE = 135 ms and TR = 1500 ms. The spectroscopic regions of interest were the bilateral basal ganglia and thalamus with a 1.0 mL spatial resolution. The data from DWI were collected by using a single shot-spin echo-echo planar imaging sequence with TR/TE: 2900/98, and imaging regions were also focused on the bilateral basal ganglia and thalamus.

Results

Nineteen of the 24 patients had abnormal T1-weighted image hyperintensity in the globus pallidus, but these lesions appeared as normal T2-weighted image intensity in the same region. Ten of the 24 patients had T1-weighted image high signal intensity in the subthalamic nucleus and appeared as normal intensity in the region for the T2-weighted images. The peak area ratios of NAA/Cho and NAA/Cr were significantly decreased (t-test, P < 0.05) in the patients compared to the controls in the basal ganglia.

Conclusion

Conventional MR imaging and 1H-MRS are important complementary tools in the diagnosis of neonatal bilirubin encephalopathy. The study provides important information for applying these MR modalities to evaluate neonates with bilirubin encephalopathy.
Literature
1.
go back to reference Govaert P, Lequin M, Swarte R et al (2003) Changes in globus pallidus with (pre) term kernicterus. Pediatrics 112:1256–1263PubMedCrossRef Govaert P, Lequin M, Swarte R et al (2003) Changes in globus pallidus with (pre) term kernicterus. Pediatrics 112:1256–1263PubMedCrossRef
2.
go back to reference Coskun A, Yikilmaz A, Kumandas S et al (2005) Hyperintense globus Pallidus on T1-weighted MR imaging in acute Kernicterus: is it common or rare? Eur Radiol 15:1263–1267PubMedCrossRef Coskun A, Yikilmaz A, Kumandas S et al (2005) Hyperintense globus Pallidus on T1-weighted MR imaging in acute Kernicterus: is it common or rare? Eur Radiol 15:1263–1267PubMedCrossRef
3.
go back to reference Sugama S, Soeda A, Eto Y et al (2001) Magnetic resonance imaging in three children with kernicterus. Pediatr Neurol 25:328–331PubMedCrossRef Sugama S, Soeda A, Eto Y et al (2001) Magnetic resonance imaging in three children with kernicterus. Pediatr Neurol 25:328–331PubMedCrossRef
4.
go back to reference Steinborn M, Seelos KC, Heuck A et al (1999) MR findings in a patient with kernicterus. Eur Radiol 9:1913–1915PubMedCrossRef Steinborn M, Seelos KC, Heuck A et al (1999) MR findings in a patient with kernicterus. Eur Radiol 9:1913–1915PubMedCrossRef
5.
go back to reference Clarke CE, Lowry M (2001) Systematic review of proton magnetic resonance spectroscopy of the striatum in parkinsonian syndromes. Eur J Neurol 8:573–577PubMedCrossRef Clarke CE, Lowry M (2001) Systematic review of proton magnetic resonance spectroscopy of the striatum in parkinsonian syndromes. Eur J Neurol 8:573–577PubMedCrossRef
6.
go back to reference Watanabe H, Fukatsu H, Katsuno M et al (2004) Multiple regional 1H-MR spectroscopy in multiple system atrophy: NAA/Cr reduction in pontine base as a valuable diagnostic marker. BMJ 75:103–109 Watanabe H, Fukatsu H, Katsuno M et al (2004) Multiple regional 1H-MR spectroscopy in multiple system atrophy: NAA/Cr reduction in pontine base as a valuable diagnostic marker. BMJ 75:103–109
7.
go back to reference Rutherford M, Counsell S, Allsop J et al (2004) Diffusion-weighted magnetic resonance imaging in term perinatal brain injury: a comparison with site of lesion and time from birth. Pediatrics 114:1004–1014PubMedCrossRef Rutherford M, Counsell S, Allsop J et al (2004) Diffusion-weighted magnetic resonance imaging in term perinatal brain injury: a comparison with site of lesion and time from birth. Pediatrics 114:1004–1014PubMedCrossRef
8.
go back to reference Barkovich AJ, Miller SP, Bartha A et al (2006) MR imaging, MR spectroscopy, and diffusion tensor imaging of sequential studies in neonates with encephalopathy. Am J Neuroradiol 27:533–547PubMed Barkovich AJ, Miller SP, Bartha A et al (2006) MR imaging, MR spectroscopy, and diffusion tensor imaging of sequential studies in neonates with encephalopathy. Am J Neuroradiol 27:533–547PubMed
9.
go back to reference Oakden WK, Moore AM, Blaser S, Noseworthy MD et al (2005) 1H-MR spectroscopic characteristics of kernicterus: a possible metabolic signature. Am J Neuroradiol 26:1571–1574PubMed Oakden WK, Moore AM, Blaser S, Noseworthy MD et al (2005) 1H-MR spectroscopic characteristics of kernicterus: a possible metabolic signature. Am J Neuroradiol 26:1571–1574PubMed
10.
go back to reference Groenendaal F, Grond J, Vries LS et al (2004) Cerebral metabolism in severe neonatal hyperbilirubinemia. Pediatrics 114:291–294PubMedCrossRef Groenendaal F, Grond J, Vries LS et al (2004) Cerebral metabolism in severe neonatal hyperbilirubinemia. Pediatrics 114:291–294PubMedCrossRef
11.
go back to reference Wennberg RP (2000) The blood-brain barrier and bilirubin encephalopathy. Cell Mol Neurobiol 20:97–109PubMedCrossRef Wennberg RP (2000) The blood-brain barrier and bilirubin encephalopathy. Cell Mol Neurobiol 20:97–109PubMedCrossRef
12.
go back to reference Turkel SB, Miller CA, Guttenberg ME et al (1982) A clinical pathologic reappraisal of kernicterus. Pediatric 69:267–272 Turkel SB, Miller CA, Guttenberg ME et al (1982) A clinical pathologic reappraisal of kernicterus. Pediatric 69:267–272
13.
go back to reference Rodrigues CMP, Sola S, Castro RE et al (2002) Perturbation of membrane dynamics in nerve cells as an early event during bilirubin-induced apoptosis. Lipid Res 43:885–894 Rodrigues CMP, Sola S, Castro RE et al (2002) Perturbation of membrane dynamics in nerve cells as an early event during bilirubin-induced apoptosis. Lipid Res 43:885–894
14.
go back to reference Harris MC, Bernbaum JC, Polin JR et al (2001) Developmental follow-up of breastfed term and near-term infants with marked hyperbilirubinemia. Pediatrics 107:1075–1080PubMedCrossRef Harris MC, Bernbaum JC, Polin JR et al (2001) Developmental follow-up of breastfed term and near-term infants with marked hyperbilirubinemia. Pediatrics 107:1075–1080PubMedCrossRef
15.
16.
go back to reference Thurnher MM, Bammer R (2006) Diffusion-weighted MR imaging (DWI) in spinal cord ischemia. Neuroradiology 48:795–801PubMedCrossRef Thurnher MM, Bammer R (2006) Diffusion-weighted MR imaging (DWI) in spinal cord ischemia. Neuroradiology 48:795–801PubMedCrossRef
17.
go back to reference Lansberg MG, Thijs VN, O’Brien MW (2001) Evolution of apparent diffusion coefficient, diffusion weighted, and T2-weighted signal intensity of acute stroke. Am J Neuroradiol 22:637–644PubMed Lansberg MG, Thijs VN, O’Brien MW (2001) Evolution of apparent diffusion coefficient, diffusion weighted, and T2-weighted signal intensity of acute stroke. Am J Neuroradiol 22:637–644PubMed
18.
go back to reference Zheng WB, Liu GR, Li PL, Wu RH (2007) Prediction of recovery from a post-traumatic coma state by diffusion-weighted imaging (DWI) in patients with diffuse axonal injury. Neuroradiology 49:271–279PubMedCrossRef Zheng WB, Liu GR, Li PL, Wu RH (2007) Prediction of recovery from a post-traumatic coma state by diffusion-weighted imaging (DWI) in patients with diffuse axonal injury. Neuroradiology 49:271–279PubMedCrossRef
19.
go back to reference Provenzale JM, Sorensen AG (1999) Diffusion-weighted MR imaging in acute stroke Theoretic considerations and clinical applications. AJR 173:1459–1467PubMed Provenzale JM, Sorensen AG (1999) Diffusion-weighted MR imaging in acute stroke Theoretic considerations and clinical applications. AJR 173:1459–1467PubMed
20.
go back to reference Barkovich AJ, Westmark KD, Bedi HS et al (2001) Proton spectroscopy and diffusion imaging on the first day of life after perinatal asphyxia: preliminary report. AJNR Am J Neuroradiol 22:1786–1794PubMed Barkovich AJ, Westmark KD, Bedi HS et al (2001) Proton spectroscopy and diffusion imaging on the first day of life after perinatal asphyxia: preliminary report. AJNR Am J Neuroradiol 22:1786–1794PubMed
Metadata
Title
Studying neonatal bilirubin encephalopathy with conventional MRI, MRS, and DWI
Authors
Xiaoyi Wang
Wulin Wu
Bob L. Hou
Ping Zhang
Ashley Chineah
Fan Liu
Weihua Liao
Publication date
01-10-2008
Publisher
Springer-Verlag
Published in
Neuroradiology / Issue 10/2008
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-008-0423-5

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