The Evaluation of Conventional MRI, Diffusion Tensor Imaging, and Arterial Spin Labeling Imaging for Early Brain Damage Caused by Neonatal Hyperbilirubinemia

Abstract

Purpose: To evaluate the early bilirubin-induced neurologic dysfunction (BIND) by T1 weighted imaging (T1WI), diffusion tensor imaging (DTI), and arterial spin labeling (ASL).Methods: Forty newborns: hyperbilirubinemia with BIND (BIND group, n=13), hyperbilirubinemia without BIND (non-BIND group, n=17), and healthy newborns (HC group, n=10). The MRI parameters of globus pallidus were measured, including the T1WI signal values from conventional MRI, apparent diffusion coefficient (ADC), the fractional anisotropy (FA), relative anisotropy (RA) and volume ratio (VR) value from DTI, and the relative cerebral blood flow (rCBF) value from ASL. The group differences were analyzed by ANOVA with Bonferroni correction. The diagnosis efficiencies were assessed by the receiver operating characteristic curve (ROC). The correlation between those parameters and serum bilirubin level was evaluated by Pearson’s correlation coefficient.Results: 1）The mean signal values of globus pallidus on T1WI and DTI parameters were significantly different among the groups (p < 0.05). The difference in T1WI between the non-BIND group and the BIND group was not significant (p >0.05). The rCBF of globus pallidus was not significantly different among the three groups (p > 0.05). 2) The T1WI, FA, and RA values were positively while the VR value was negatively correlated with serum bilirubin level (r =0.763, 0.585, 0.586, -0.544 respectively, p < 0.05). The ADC value and rCBF were not correlated with serum bilirubin (r = -0.050, -0.275 respectively, p > 0.05). 3) The area under curve (AUC) of T1WI, FA, RA, VR was 0.953, 0.897, 0.897, 0.860 respectively. And the AUC of the diagnosis method, combined T1WI, FA, RA and VR, was 0.987.Conclusion: The index, combined T1WI and DTI parameters, was important for diagnosing early hyperbilirubinemia brain injury. ASL might not have function on diagnosing early hyperbilirubinemia brain injure.