脑磁共振成像对严重未结合高胆红素血症婴儿神经发育结局的预测价值：系统综述。

IF 2.3 3区医学 Q3 CLINICAL NEUROLOGY

European Journal of Paediatric Neurology Pub Date : 2024-09-27 DOI:10.1016/j.ejpn.2024.09.010

Noortje M. van der Meulen , Karin L. Meijers , Jeroen Dudink , Laura A. van de Pol

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引用次数: 0

摘要

背景：对于严重非结合性高胆红素血症（高于交换性输血水平）婴儿脑部核磁共振成像对长期神经发育结果（NDO）的预测价值存在争议：研究严重未结合高胆红素血症（足月前）婴儿的核磁共振成像结果能否预测≥12个月时的NDO，并确定核磁共振成像的最佳时机：资料来源：PubMed 和 Embase。最后更新时间：2024 年 6 月 14 日：纳入在24个月前接受核磁共振成像且在≥12个月时报告有NDO的严重未结合高胆红素血症（足月前）婴儿的研究：数据提取：提取患者特征、MRI 和 NDO 的详细信息：结果：搜索结果显示有 732 项研究，其中 22 项被纳入。获得了120名婴儿的个体信息（核磁共振成像时间：早期（≤6周）n = 75，晚期（>6周）n = 19，未知n = 26）。在所有组别中，磁共振成像异常对 NDO 受损的阳性预测值（PPV）很高（77.5%）。与早期 MRI 相比，晚期 MRI 的 PPV 要高得多，分别为 92.3% 和 71.7%。全组正常 MRI 对正常 NDO 的阴性预测值较低（29.0%），晚期 MRI 对正常 NDO 的阴性预测值再次高于早期 MRI，分别为 50.0% 对 27.3%：局限性：由于研究设计存在很大的异质性，因此无法对结果进行定量综合。此外，对预后受损患者的选择偏倚可能会影响我们的结果：脑磁共振成像可作为重度未结合高胆红素血症婴儿NDO的预后工具，无论是早期还是晚期，但每个时机都有其固有的局限性。有必要进一步开展前瞻性研究。

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Predictive value of brain MRI for neurodevelopmental outcome in infants with severe unconjugated hyperbilirubinemia: A systematic review

Context

Debate exists regarding predictive value of brain MRI for long-term neurodevelopmental outcome (NDO) in infants with severe unconjugated hyperbilirubinemia (above exchange transfusion levels).

Objective

To investigate whether MRI findings among (pre-)term infants with severe unconjugated hyperbilirubinemia can predict NDO at ≥ 12 months and determine optimal timing for MRI.

Data sources

PubMed and Embase. Last update: June 14, 2024.

Study selection

Studies in which (pre-)term infants with severe unconjugated hyperbilirubinemia who underwent an MRI before 24 months and had a reported NDO at ≥ 12 months were included.

Data extraction

Patient characteristics, MRI and NDO details were extracted.

Results

The search yielded 732 studies, of which 22 were included. Individual patient information was obtained for 120 infants (MRI-timing: early (≤6 weeks) n = 75, late (>6 weeks) n = 19, unknown n = 26). Positive predictive value (PPV) of abnormal MRI in the total group for impaired NDO was high (77.5 %). The PPV of late compared to early MRI was much higher, 92.3 % versus 71.7 %. Negative predictive value of normal MRI for normal NDO in the total group was low (29.0 %) and again higher in late compared to early MRI, 50.0 % versus 27.3 %.

Limitations

Quantitative synthesis of results was impossible due to large heterogeneity in study designs. Furthermore, selection bias towards patients with impaired outcome might have influenced our results.

Conclusions

Brain MRI can serve as prognostic tool for NDO in infants with severe unconjugated hyperbilirubinemia, both in early and late stages, but each timing has inherent constraints. Further prospective studies are necessary.

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来源期刊

European Journal of Paediatric Neurology 医学-临床神经学

CiteScore

6.30

自引率

3.20%

发文量

115

审稿时长

81 days

期刊介绍： The European Journal of Paediatric Neurology is the Official Journal of the European Paediatric Neurology Society, successor to the long-established European Federation of Child Neurology Societies. Under the guidance of a prestigious International editorial board, this multi-disciplinary journal publishes exciting clinical and experimental research in this rapidly expanding field. High quality papers written by leading experts encompass all the major diseases including epilepsy, movement disorders, neuromuscular disorders, neurodegenerative disorders and intellectual disability. Other exciting highlights include articles on brain imaging and neonatal neurology, and the publication of regularly updated tables relating to the main groups of disorders.