title: Magnetic resonance imaging of bilirubin encephalopathy: current limitations and future promise.
abstract: Infants with chronic bilirubin encephalopathy often demonstrate abnormal bilateral, symmetric, high-signal intensity on T2-weighted magnetic resonance imaging of the globus pallidus and subthalamic nucleus, consistent with the neuropathology of kernicterus. Early magnetic resonance imaging of at-risk infants, while frequently showing increased T1-signal in these regions, may give false-positive findings due to the presence of myelin in these structures. Advanced magnetic resonance imaging including diffusion-weighted imaging, magnetic resonance spectroscopy, and diffusion tensor imaging with tractography may shed new insights into the pathogenesis of bilirubin-induced brain injury and the neural basis of long-term disability in infants and children with chronic bilirubin encephalopathy.
authors.affiliation: Department of Pediatric Radiology, Children׳s Hospital of Pittsburgh of the University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Wisnowski
authors.affiliation: Department of Pediatric Radiology, Children׳s Hospital of Pittsburgh of the University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Ashok
authors.initials: A
authors.lastname: Panigrahy
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Painter
authors.affiliation: Division of Newborn Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213. Electronic address: jwatchko@mail.magee.edu.
authors.forename: Jon F
authors.initials: JF
authors.lastname: Watchko
mesh_terms: D000208:Acute Disease; D000818:Animals; D001663:Bilirubin; D001921:Brain / Q000473:pathology*; D002908:Chronic Disease; D038524:Diffusion Magnetic Resonance Imaging; D004195:Disease Models, Animal; D005189:False Positive Reactions; D005917:Globus Pallidus / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases; D007647:Kernicterus / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000639:trends*; D009682:Magnetic Resonance Spectroscopy; D051381:Rats; D020531:Subthalamic Nucleus / Q000473:pathology
chemical_list: D001663:Bilirubin
keywords: Kernicterus; Magnetic resonance spectroscopy; Myelination; Tractography