Magnetic resonance imaging of bilirubin encephalopathy: current limitations and future promise

Semin Perinatol. 2014 Nov;38(7):422-8. doi: 10.1053/j.semperi.2014.08.005. Epub 2014 Sep 27.


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.

Keywords: Kernicterus; Magnetic resonance spectroscopy; Myelination; Tractography.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Disease
  • Animals
  • Bilirubin
  • Brain / pathology*
  • Chronic Disease
  • Diffusion Magnetic Resonance Imaging
  • Disease Models, Animal
  • False Positive Reactions
  • Globus Pallidus / pathology
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases
  • Kernicterus / pathology*
  • Magnetic Resonance Imaging / methods*
  • Magnetic Resonance Imaging / trends*
  • Magnetic Resonance Spectroscopy
  • Rats
  • Subthalamic Nucleus / pathology


  • Bilirubin