İndirekt Hiperbilirubinemisi Olan Yenidoğanlarda Manyetik Rezonans Görüntüleme Bulguları: Yüksek Bilirubin Düzeyleri ile T1-Ağırlıklı Görüntülerde Artmış Sinyal Yoğunluğu Arasında İlişki Var mı?

Abstract

Objective: To examine the findings of magnetic resonance imaging (MRI) in newborns with indirect hyperbilirubinemia and disclose any relationship between high levels of bilirubin and increased in signal intensity on T1-weighted images. Material and Methods: The study included 35 newborns with indirect hyperbilirubinemia. Clinical findings, bilirubin levels and MRI images were evaluated. Results: Of the study population, 20 (57.1%) were females and 15 (42.9%) were males. According to the gestational age, 30 cases were defined as term and five as preterm. An abnormal and bilaterally symmetrical increase in signal intensity was observed in the globus pallidus of 26 (74.3%) newborns on T1-weighted images. A statistically significant relation was determined between the peak value of bilirubin and increased signal intensity on the T1-weighted images (p= 0.004). Jaundice, lethargy, hypertonia, hypotonia and poor feeding were among the clinical findings. The mean serum bilurubin level was found as 38.6 ± 8.9 mg/dl (Range between 25 to 58 mg/dl). Major group incompatibility was detected in seven (20%) and Rh subgroup incompatibility in four (11.4%) of the cases. Glucose 6 phosphate dehydrogenase enzyme activity was reduced in eight (22.8%) cases. The MRI studies were performed between the days 5 and 30, following parturition. Conclusion: There seem to be a relationship between the peak levels of indirect bilirubin and higher T1-weighted signal intensity on MRI of the central nervous system. No relationship was determined between the levels of indirect bilirubin and the area of the central nervous system with increased signal intensity.