Changes and Correlation Analysis of Transcutaneous Bilirubin, Serum Bilirubin, and Magnetic Resonance Imaging Findings before and after Phototherapy in Neonatal Hyperbilirubinemia

Abstract

Background: Hyperbilirubinemia is a commonly encountered condition during neonatal period. Accumulation of unconjugated bilirubin can cause jaundice, which affects the skin or other tissues in newborns. Furthermore, hyperbilirubinemia directly affects the energy metabolism and tissue structure of the brain. This cytotoxicity seriously threatens the safety of newborns. Aim: To investigate changes in transcutaneous bilirubin (TCB), transserum bilirubin (TSB), and magnetic resonance imaging (MRI) T1-weighted imaging (T1WI) mean signal of the pallidum in neonates with hyperbilirubinemia and the effect of intense light therapy. Methods: The study included newborns with hyperbilirubinemia treated at the No. 215 Hospital of Shaanxi Nuclear Industry from February 2019 to February 2021. All children received basic treatment combined with strong light therapy. Changes in TCB, serum TSB, MRI T1WI mean signal parameters of the pallidum, serum immunoglobulin, and neonatal behavioral neurological assessment scale (NBNA) scores before and after treatment were recorded, and the relationship between TCB, TSB, and MRI T1WI pallidum average signal parameters and NBNA score before treatment was examined. Results: A total of 100 neonates (54 males and 46 females) with hyperbilirubinemia were included. The gestational age was 37–40 (average: 38.5 ± 0.7) weeks, birth weight was 2964–3581 (average: 3298.4 ± 96.2) g, and the age was 7–26 (average: 14.8 ± 3.5) days. There were 38 cesarean sections and 62 vaginal deliveries. After intense light therapy, the average TCB values of the forehead, anterior chest, perineum, and three parts of children after treatment were significantly lower than those before treatment (p < 0.05). The serum TSB level after treatment was significantly lower than that before treatment (p < 0.05). The mean signal values of the left, right, and bilateral globus pallidus after treatment were significantly lower than those before treatment (p < 0.05). There was no significant difference between the signal difference of the left, right, and bilateral globus pallidus and frontal lobe after and before treatments (p > 0.05). There was a significant negative correlation between the TCB and TSB levels and NBNA scores, and a positive correlation was noted between the TCB and TSB levels and the average signal value of the bilateral globus pallidus (p < 0.05). Conclusions: The mean signal values of TCB, serum TSB, and MRI T1WI pallidum in children with hyperbilirubinemia that were significantly increased before treatment, significantly decreased after treatment. TCB and serum TSB are positively correlated with the mean signal value of MRI T1WI pallidum and the NBNA score, which can reflect the brain injury of children to a certain extent.