title: Usefulness of (1) H-MRS in differentiating bilirubin encephalopathy from severe hyperbilirubinemia in neonates.
abstract: OBJECTIVE
  To evaluate the usefulness of (1) H-MRS in differentiating bilirubin encephalopathy from severe hyperbilirubinemia in neonates.
  
  
  METHODS
  There were 11 patients enrolled in the neonatal bilirubin encephalopathy (NBE) group, 8 patients in the neonatal hyperbilirubinemia (NH) group, and 9 healthy, age-matched neonates were included as controls. All patients and controls underwent (1) H-MRS and conventional magnetic resonance (MR) sequences. The spectroscopic regions of interest were the bilateral basal ganglia and the thalamus, and a spatial resolution of 1.0 cm(3) was obtained.
  
  
  RESULTS
  Peak-area ratios of NAA/Cr and NAA/ Cho in the basal ganglia were found to be significantly lower for the NBE group compared with the NH and control groups (P < 0.05). In contrast, there was no significant difference in the NAA/Cr ratios calculated for basal ganglia of the NH and control groups. Peak-area ratios of NAA/Cr and NAA/Cho in the thalamus were decreased for the NBE group compared with the NH and control groups, but the differences were not significant (P > 0.05). There was a significant correlation between NAA/Cr ratios for basal ganglia and the total serum bilirubin (TSB) peak level in the NBE group (P < 0.05).
  
  
  CONCLUSIONS
  (1) H-MRS is useful in the differential diagnosis of NBE from severe hyperbilirubinemia in neonates, especially when the symptoms of NBE are atypical (subtle) and MRI does not reveal clear abnormalities.
authors: Department of Radiology, Longgang District Central Hospital of Shen Zhen, Shenzhen, Guangdong Province, PR China. wuwulinvip@sina.com
authors: Wulin
authors: W
authors: Wu
authors: Ping
authors: P
authors: Zhang
authors: Xiaoyi
authors: X
authors: Wang
authors: Ashley
authors: A
authors: Chineah
authors: Mingwu
authors: M
authors: Lou
mesh_terms: D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D002794:Choline / Q000378:metabolism*; D003404:Creatinine / Q000378:metabolism*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000175:diagnosis* / Q000378:metabolism; D007231:Infant, Newborn; D007647:Kernicterus / Q000175:diagnosis* / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D011522:Protons; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D011522:Protons; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003404:Creatinine; D002794:Choline
keywords: 1H-MRS; MRI; neonatal bilirubin encephalopathy; neonatal hyperbilirubinemia; neonate