Neonatal Jaundice: Correspondence
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To the Editor: We read with interest the review article on imaging in neonatal hyperbilirubinemia and found it very relevant and useful . However, we would like to make certain points which should be kept in mind while managing the neonates with severe hyperbilirubinemia.
The authors rightly stated that the early magnetic resonance (MR) study in acute bilirubin encephalopathy (ABE) is characterized by hyperintensity on T1 and iso-to-hyperintense on T2 weighted images. Therefore, in routine clinical practice whenever we see T1 hyperintensity in globus pallidus and subthalamic nucleus in a neonate with jaundice, we tend to diagnose it as ABE. However, these findings may be seen even in a healthy neonate. In late preterm and term neonates, the normal myelination pattern may be a masquerader of ABE. Due to its high lipid content, the myelin appears hyperintense on T1 weighted images. At term gestation, myelin is present in specific tracts in the brainstem, corticospinal tracts as well...