Background and Objective: The abnormal T1-weighted imaging of MRI can be used to characterize neonatal acute bilirubin encephalopathy (ABE) in newborns, but has limited use in evaluating the severity and prognosis of ABE. This study aims to assess the value of diffusion kurtosis imaging (DKI) in detecting ABE and understanding its pathogenesis. Method: Seventy-six newborns with hyperbilirubinemia were grouped into three groups (mild group, moderate group, and severe group) based on serum bilirubin levels. All the patients underwent conventional MRI and DKI serial, as well as 40 healthy full-term infants (control group). The regions of interest (ROIs) were the bilateral globus pallidus, dorsal thalamus, frontal lobe, auditory radiation, superior temporal gyrus, substantia nigra, hippocampus, putamen, and inferior olivary nucleus. The values of mean diffusivity (MD), axial kurtosis (AK), radial kurtosis (RK), and mean kurtosis (MK), and fractional anisotropy (FA), radial diffusivity (RD), and axis diffusivity (AD) of the ROIs were evaluated. All newborns were followed up and evaluated using the Denver Development Screening Test (DDST). According to the follow-up results, the patients were divided into the normal group, the suspicious abnormal group, and the abnormal group. Result: Compared with the control group, significant differences were observed with the increased MK of dorsal thalamus, AD of globus pallidus in the moderate group, and increased RD, MK, AK, and RK value of globus pallidus, dorsal thalamus, auditory radiation, superior temporal gyrus, and hippocampus in the severe group. The peak value of total serum bilirubin was moderately correlated with the MK of globus pallidus, dorsal thalamus, and auditory radiation and was positively correlated with the other kurtosis value. Out of 76 patients, 40 finished the DDST, and only 9 patients showed an abnormality. Compared with the normal group, the AK value of inferior olivary nucleus showed significant differences (p < 0.05) in the suspicious abnormal group, and the MK of globus pallidus, temporal gyrus, and auditory radiation; RK of globus pallidus, dorsal thalamus, and auditory radiation; and MD of globus pallidus showed significant differences (p < 0.05) in the abnormal group. Conclusion: DKI can reflect the subtle structural changes of neonatal ABE, and MK is a sensitive indicator to indicate the severity of brain damage.

中文翻译：

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新生儿急性胆红素脑病的磁共振图像：弥散峰度成像研究。

背景与目的：MRI 异常 T1 加权成像可用于表征新生儿急性胆红素脑病 (ABE)，但在评估 ABE 的严重程度和预后方面用途有限。本研究旨在评估弥散峰度成像 (DKI) 在检测 ABE 和了解其发病机制方面的价值。方法：76名高胆红素血症新生儿根据血清胆红素水平分为三组（轻度组、中度组、重度组）。所有患者均行常规MRI和DKI系列，以及40名健康足月婴儿（对照组）。感兴趣区域 (ROI) 是双侧苍白球、背侧丘脑、额叶、听觉辐射、颞上回、黑质、海马、壳核和下橄榄核。ROI 的平均扩散率 (MD)、轴向峰态 (AK)、径向峰态 (RK) 和平均峰态 (MK) 以及各向异性分数 (FA)、径向扩散率 (RD) 和轴向扩散率 (AD) 的值被评估。使用丹佛发育筛查测试 (DDST) 对所有新生儿进行随访和评估。根据随访结果将患者分为正常组、可疑异常组和异常组。结果：与对照组相比，中度组丘脑背侧MK、苍白球AD增加，苍白球、丘脑背侧、听觉辐射、RD、MK、AK、RK值增加，差异有统计学意义。严重组为颞上回和海马。血清总胆红素峰值与苍白球、丘脑背侧和听觉辐射的MK呈中度相关，与其他峰度值呈正相关。在 76 名患者中，40 名完成了 DDST，只有 9 名患者出现异常。与正常组相比，可疑异常组下橄榄核AK值、苍白球MK、颞回MK、听觉辐射MK值有显着差异（p<0.05）；苍白球、背侧丘脑和听觉辐射的 RK；苍白球的MD和MD在异常组中显示出显着差异（p <0.05）。结论：DKI可以反映新生儿ABE的细微结构变化，MK是指示脑损伤严重程度的敏感指标。和听觉辐射，并与其他峰度值呈正相关。在 76 名患者中，40 名完成了 DDST，只有 9 名患者出现异常。与正常组相比，可疑异常组下橄榄核AK值、苍白球、颞回、听觉辐射MK值有显着差异（p<0.05）；苍白球、背侧丘脑和听觉辐射的 RK；苍白球的MD和MD在异常组中显示出显着差异（p <0.05）。结论：DKI可以反映新生儿ABE的细微结构变化，MK是指示脑损伤严重程度的敏感指标。和听觉辐射，并与其他峰度值呈正相关。在 76 名患者中，40 名完成了 DDST，只有 9 名患者出现异常。与正常组相比，可疑异常组下橄榄核AK值、苍白球、颞回、听觉辐射MK值有显着差异（p<0.05）；苍白球、背侧丘脑和听觉辐射的 RK；苍白球的MD和MD在异常组中显示出显着差异（p <0.05）。结论：DKI可以反映新生儿ABE的细微结构变化，MK是指示脑损伤严重程度的敏感指标。与正常组相比，可疑异常组下橄榄核AK值、苍白球、颞回、听觉辐射MK值有显着差异（p<0.05）；苍白球、背侧丘脑和听觉辐射的 RK；苍白球的MD和MD在异常组中显示出显着差异（p <0.05）。结论：DKI可以反映新生儿ABE的细微结构变化，MK是指示脑损伤严重程度的敏感指标。与正常组相比，可疑异常组下橄榄核AK值、苍白球、颞回、听觉辐射MK值有显着差异（p<0.05）；苍白球、背侧丘脑和听觉辐射的 RK；苍白球的MD和MD在异常组中显示出显着差异（p <0.05）。结论：DKI可以反映新生儿ABE的细微结构变化，MK是指示脑损伤严重程度的敏感指标。苍白球的MD和MD在异常组中显示出显着差异（p <0.05）。结论：DKI可以反映新生儿ABE的细微结构变化，MK是指示脑损伤严重程度的敏感指标。苍白球的MD和MD在异常组中显示出显着差异（p <0.05）。结论：DKI可以反映新生儿ABE的细微结构变化，MK是指示脑损伤严重程度的敏感指标。