Brain Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy Findings of Children with Kernicterus

Sarı, Sahabettin; Yavuz, Alpaslan; Batur, Aabdussamet; Bora, Aydın; Çaksen, Hüseyîn

doi:10.12659/pjr.892643

Cited by 22 publications

(5 citation statements)

References 29 publications

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“…This agrees with Aly and Montaser [14], who reported only 16% of the ABE group showed an excessively high signal intensity in the globus pallidus. Also, our results agree with Sari et al [19], who found that only 22.2% of their ABE group had abnormal MRIs. Thus, normal MRI does not exclude ABE.…”

Section: Discussionsupporting

confidence: 93%

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Magnetic resonance spectroscopy and auditory brain-stem response audiometry as predictors of bilirubin-induced neurologic dysfunction in full-term jaundiced neonates

Zidan,

Rowisha,

Nassar

et al. 2023

Eur J Pediatr

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The purpose of this research was to define the functions of MRS and ABR as predictors of bilirubin-induced neurologic dysfunction (BIND) in full-term neonates who required intervention (phototherapy and/or exchange transfusion). This prospective cohort study was done at the NICU of Tanta University Hospitals over a 2-year duration. Fifty-six full-term neonates with pathological unconjugated hyperbilirubinemia were divided according to MRS and ABR findings into 2 groups: group (1) included 26 cases with mild acute bilirubin encephalopathy (BIND-M score 1–4). Group (2) included 30 cases with neonatal hyperbilirubinemia only. In addition, 20 healthy neonates with similar ages were employed as the controls. When compared to group 2 and the control group, group 1’s peak-area ratios of NAA/Cr and NAA/Cho were found to be significantly reduced (P < 0.05). As compared to group 2 and the control group, group 1’s Lac/Cr ratio was significantly greater (P < 0.05), but the differences were not significant for group 2 when compared to the control group. Waves III and V peak latencies, I–III, and I–V interpeak intervals were significantly prolonged in group 1 in comparison to group 2 and controls (P < 0.05) with no significant difference between group 2 and control group. Conclusion: When the symptoms of ABE are mild and MRI does not show any evident abnormalities, MRS and ABR are helpful in differentiating individuals with ABE from patients with neonatal hyperbilirubinemia. Trial registration: ClinicalTrials.gov, Identifier: NCT06018012. What is Known:• MRS can be used as a diagnostic and prognostic tool for the differential diagnosis of patients with acute bilirubin encephalopathy, from patients with neonatal hyperbilirubinemia What is New:• ABR is a useful diagnostic and prognostic tool in the care and management of neonates with significantly raised bilirubin. It can be used as early predictor of acute bilirubin encephalopathy in the earliest stage of auditory damage caused by bilirubin.

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Section: Discussionsupporting

confidence: 93%

“…Also, our results agree with Sari et al . [ 19 ], who found that only 22.2% of their ABE group had abnormal MRIs. Thus, normal MRI does not exclude ABE.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance spectroscopy and auditory brain-stem response audiometry as predictors of bilirubin-induced neurologic dysfunction in full-term jaundiced neonates

Zidan,

Rowisha,

Nassar

et al. 2023

Eur J Pediatr

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“…The pipeline of the feature identification and analysis processes is summarized in Figure 1. For the current study, we only focused on the abnormalities in globus pallidus, which is one of the earliest and most sensitive regions affected by the bilirubin toxicity in ABE (26). An abnormal appearance of increased signal intensity on T 1 -weighted spin echo images in the region is shown in Figure 2, allowing for extracting globus pallidus from T 1 -weighted images as the region of interest (ROI).…”

Section: Methodsmentioning

confidence: 99%

Machine Learning Assisted MRI Characterization for Diagnosis of Neonatal Acute Bilirubin Encephalopathy

Liu

Zhang

et al. 2019

Front. Neurol.

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Background: The use of magnetic resonance imaging (MRI) in diagnosis of neonatal acute bilirubin encephalopathy (ABE) in newborns has been limited by its difficulty in differentiating confounding image contrast changes associated with normal myelination. This study aims to demonstrate the feasibility of building a machine learning prediction model based on radiomics features derived from MRI to better characterize and distinguish ABE from normal myelination.Methods: In this retrospective study, we included 32 neonates with clinically confirmed ABE and 29 age-matched controls with normal myelination. Radiomics features were extracted from the manually segmented region of interest (ROI) on T1-weighted spin echo images, followed by the feature selection using two-sample independent t-test, least absolute shrinkage and selection operator (Lasso) regression, and Pearson's correlation matrix. Additional feature quantifying the relative mean intensity of ROI was defined and calculated. A prediction model based on the selected features was built to classify ABE and normal myelination using multiple machine learning classifiers and a leave-one-out cross-validation scheme. Receiver operating characteristics (ROC) analysis was used to evaluate the prediction performance with the area under the curve (AUC) and feature importance ranked based on the Fisher score.Results: Among 1319 radiomics features, one radiologist-defined intensity-based feature and 12 texture features were selected as the most discriminative features. Based on these features, decision trees had the best classification performance with the largest AUC of 0.946, followed by support vector machine (SVM), tree-bagger, logistic regression, Naïve Bayes, discriminant analysis, and k-nearest neighborhood (KNN), which have an AUC of 0.931, 0.925, 0.905, 0.891, 0.883, and 0.817, respectively. The relative mean intensity outperformed other 12 texture features in differentiating ABE from controls.Conclusions: The results from this study demonstrated a new strategy of characterizing ABE-induced intensity and morphological changes in MRI, which are difficult to be recognized, interpreted, or quantified by the routine experience and visual-based reading strategy. With more quantitative and objective measurements, the reported machine learning assisted radiomics features-based approach can improve the diagnosis and support clinical decision-making.

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“…Nguefack et al reported that underweight and growth retardation were the most common forms of malnutrition in children with cerebral palsy 15 . It is also well established that the poor growth and weight of children with cerebral palsy have multifactorial etiologies, associating nutritional factors related to poor nutrient intake (pharyngeal motor disorders), environmental factors, and endocrine factors including growth hormone deficiency 19 . Denver developmental screening test II (DDSTII) is one of the most widely used scales in the developmental assessment of children with neurological disorders 1 , 12 , 14 .…”

Section: Discussionmentioning

confidence: 99%

Imaging of developmental delay in black African children: A hospital-based study in Yaoundé-Cameroon

Nguefack¹,

Fongue²,

Tague³

et al. 2023

Afr H. Sci.

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Background: The purpose of this study was to describe the anomalies observed on imaging for developmental delay in black African children. Methods: It was a descriptive cross-sectional study, which included children aged between 1 month to 6 years with developmental delay and had done a brain MRI and/or CT scan. Results: We included 94 children, 60.6% of whom were males. The mean age was 32.5 ± 6.8 months. A history of perinatal asphyxia found in 55.3% of cases. According to the Denver developmental II scale, profound developmental delay observed in 35.1% of cases, and severe developmental delay in 25.5%. DD was isolated in 2.1% of cases and associated with cerebral palsy, pyramidal syndrome, and microcephaly in respectively 83%, 79.8%, and 46.8% of cases. Brain CT scan and MRI accounted for 85.1% and 14.9% respectively. The tests were abnormal in 78.7% of the cases, and cerebral atrophy was the preponderantanomaly (cortical atrophy = 80%, subcortical atrophy = 69.3%). Epileptic patients were 4 times more likely to have abnormal brain imaging (OR = 4.12 and p = 0.05),. We did not find a link between the severity of psychomotor delay and the presence of significant anomalies in imaging. Conclusion: In our context, there is a high prevalence of organic anomalies in the imaging of psychomotor delay, which were dominated by cerebral atrophy secondary to hypoxic ischemic events. Keywords: developmental delay; brain MRI; CT scan; children.

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Brain Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy Findings of Children with Kernicterus

Cited by 22 publications

References 29 publications

Magnetic resonance spectroscopy and auditory brain-stem response audiometry as predictors of bilirubin-induced neurologic dysfunction in full-term jaundiced neonates

Magnetic resonance spectroscopy and auditory brain-stem response audiometry as predictors of bilirubin-induced neurologic dysfunction in full-term jaundiced neonates

Machine Learning Assisted MRI Characterization for Diagnosis of Neonatal Acute Bilirubin Encephalopathy

Imaging of developmental delay in black African children: A hospital-based study in Yaoundé-Cameroon

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