【摘要】 目的:探讨MRI及MRS对新生儿急性胆红素脑病的诊断效能,并进行比较。方法:回顾性分析我院收治的高胆红素血症患儿198例的临床资料,依据是否发生急性胆红素脑病分为脑病组和危险组,同期选取健康新生儿30例作为对照组。所有研究对象均行MRI及MRS分析N-乙酰天门冬氨酸（NAA）、胆碱（Cho）、肌酸（Cr）,并以临床诊断为对照,统计分析MRI及MRS结果。结果:MRI示急性胆红素脑病患儿苍白球区主要以T₁WI呈高信号为特征,T₂WI呈等或高信号;DWI未见特殊变化（均呈等信号）;MRS示急性胆红素脑病患儿可见Cho峰、NAA峰及Cr峰,但NAA峰普遍较低,部分患儿NAA峰明显低于Cr峰。ROC曲线显示,MRI诊断新生儿急性胆红素脑病的敏感度、特异度、准确度分别为84.33%、88.28%、86.84%,分别低于MRS的93.98%、95.17%、94.74%（均P<0.05）。结论:MRI及MRS对诊断新生儿急性胆红素脑病均有良好的敏感度、特异度和准确度,但MRS诊断效能更高,有利于为临床早期干预提供更可靠证据。更多还原

【Abstract】 Objective :To discuss the diagnostic performance compared of magnetic resonance imaging(MRI) and magnetic resonance spectral imaging(MRS) in neonatal acute bilirubin encephalopathy.Methods:198 cases of children with high blood bilirubin were retrospectively analyzed from September 2012 to June 2012 in our hospital.According to whether acute bilirubin encephalopathy,all patients were divided into encephalopathy group and dangerous group,30 cases healthy newborn were chosen as control group at the same time,all subjects were given MRI and MRS examination,analyzed n-acetyl aspartate(NAA),choline(Cho),creatine(Cr),with clinical diagnosis for comparison,analyzed all the research object of MRI and MRS detection results.Results:MRI signs showed that children with acute bilirubin encephalopathy in newborn,pallidum mainly characterized by T1WI high signal,T2WI iso-signal or high signal,and no signal change on DWI.MRS signs showed that acute bilirubin encephalopathy in newborn children with visible Cr,Cho,NAA peak,but generally lower NAA peak,some cases significantly lower than that of Cr peak.ROC curve analysis showed that,the MRI examination in the diagnosis of neonatal acute bilirubin encephalopathy,the sensitivity,specificity and accuracy were 84.33%,88.28%,86.84%,respectively.MRS testing diagnostic sensitivity,specificity and accuracy were 93.98%,95.17% and 94.74%,respectively.the former sensitivity,specificity,and accuracy were significantly lower than the latter(P< 0.05).Conclusions:MRI and MRS in the diagnosis of acute bilirubin encephalopathy in newborn with good sensitivity,specificity and accuracy,but MRS detection diagnosis efficiency is higher,it is beneficial to provide more reliable evidence for clinical early intervention.更多还原