2型糖尿病患者与特定功能相关大脑皮层ADC值的MRI研究

Type 2 diabetes and apparent diffusion coefficients of the cerebral cortex associated with specific functions on brain MRI

目的探讨2型糖尿病患者与记忆、情感及视觉相关的脑皮层与正常人的表观扩散系数(apparent diffusion coefficients,ADC)值的差异性。材料与方法将40例2型糖尿病依据视网膜病变程度分为Ⅰ组(增殖性视网膜病变)及Ⅱ组(单纯性视网膜病变)各20例,另外收集20例年龄相近的健康志愿者(Ⅲ组),行1.5 T MRI常规和弥散加权成像(diffusion weighted imaging,DWI)扫描,测量各组两侧额中回、颞上回和楔回脑皮层的ADC值。结果 3组在MRI常规平扫T1WI及T2WI上图像差别不大。Ⅰ、Ⅱ及Ⅲ组双侧额中回、颞上回脑皮层ADC值依次降低;Ⅰ、Ⅱ两组右侧额中回脑皮层的ADC值与病期长短呈正相关。结论Ⅰ、Ⅱ及Ⅲ组双侧额中回、颞上回脑皮层ADC值依次降低,提示Ⅰ、Ⅱ组患者相应脑皮层的神经元变性、凋亡,证明2型糖尿病与脑损伤之间有一定的相关性,且随着疾病进展,脑损伤有进一步加重的趋势。

Objective： To detect whether there is any change of apparent diffusion coefficients（ADC） levels in different sites of the brain, particularly in areas associated with the memory, the emotion and the vision in type 2 diabetic patients with retinopathy by measuring diffusion-weighted imaging（DWI）. Materials and Methods： Conventional magnetic resonance imaging（MRI） and DWI of the brain were obtained from 40 diabetic patients： 20 patients with proliferative diabetic retinopathy（group Ⅰ）, 20 diabetic patients with simple diabetic retinopathy（group Ⅱ） and 20 age-matched healthy volunteers（group Ⅲ）. ADC values of midfrontal gyrus, superior temporal gyrus and cuneate gyrus were obtained. Results： There is no significant difference in routine T1 or T2 weighted imaging between the three group. The ADC values of bilateral midfrontal gyrus and superior temporal gyrus cortex significantly increased in group Ⅰ and Ⅱ compared to group Ⅲ（P〈0.05）. The duration of disease positively correlated with ADC values of the right midfrontal gyrus in group Ⅰ and Ⅱ. Conclusion： We found increases in ADC values supporting the neuronal degeneration and poptosis in some regions, especially in midfrontal gyrus and superior temporal gyrus by DWI in the diabetic patients with retinopathy. This result supports the association between diabetic retinopathy and brain injury, and with the progression of disease, the brain injury may be further aggravation.