目的:确定患有新生儿胆汁淤积性肝病的儿童在脑影像学研究中是否有并发和后期的发现,这些发现可归因于胆汁淤积,有助于理解受损的神经心理学发育。
方法:OvidMEDLINE和EMBASE于2022年7月21日进行了搜索,并于2023年3月26日进行了更新。包括对18岁以下的新生儿胆汁淤积儿童的研究,以及在诊断时或以后的脑部扫描。排除的研究是非英语的,非人类,评论或会议摘要。数据是根据人口统计学提取的,脑成像发现,治疗和结果。结果按疾病类别进行了总结。使用JBI关键评估工具评估偏差风险。
结果:搜索产生了12011份报告,其中1261人接受了全文审查,89人符合纳入条件。出血是最常见的发现,尤其是胆管阻塞的儿童,包括胆道闭锁.肝移植后,一些发现得以解决。
结论:新生儿胆汁淤积患儿脑影像学改变,这可能在受损的神经心理发育中起作用,但需要采用结构化评估的纵向临床研究,以更好地确定损害的病因.
OBJECTIVE: To determine if children with neonatal cholestatic liver disease had concurrent and later findings on brain imaging studies that could be attributed and the cholestasis to contribute to the understanding of the impaired neuropsychological development.
METHODS: Ovid MEDLINE and EMBASE were searched on July 21, 2022, and updated on March 26, 2023. Studies with children under 18 years of age with neonatal cholestasis and a brain scan at the time of diagnosis or later in life were included. Excluded studies were non-English, non-human, reviews or conference abstracts. Data were extracted on demographics, brain imaging findings, treatment and outcome. The results were summarised by disease categories. Risk of bias was assessed using JBI critical appraisal tools.
RESULTS: The search yielded 12 011 reports, of which 1261 underwent full text
review and 89 were eligible for inclusion. Haemorrhage was the most common finding, especially in children with bile duct obstruction, including biliary atresia. Some findings were resolved after liver transplantation.
CONCLUSIONS: Children with neonatal cholestasis had changes in brain imaging, which might play a role in impaired neuropsychological development, but longitudinal clinical research with structured assessment is needed to better qualify the aetiology of the impairment.