Ⅱ型糖尿病患者脑实质微结构改变的扩散峰度成像研究

Study on Diffusion Kurtosis Imaging in Cerebric Microstructure Changes of Patients with Type Ⅱ Diabetes Mellitus

目的采用扩散峰度成像监测Ⅱ型糖尿病患者早期隐匿性脑损伤。方法31例无认知障碍的Ⅱ型糖尿病患者作为实验组,平均年龄(58±4)岁;年龄、性别、文化程度匹配的26例常规体检者作为对照组。对两组进行脑部扩散峰度成像及认知力评估,比较组间脑不同区域平均弥散率(MD值)、弥散各向异性分数(FA值)及平均峰度(MK值)差异。结果在正常对照组(NC)和病例组(TDM)间,FA(双侧均值)值差异无统计学意义(P>0.05)。MD值(双侧均值)差异有统计学意义的部位为枕叶白质区、豆状核、丘脑;MK值(双侧均值)差异有统计学意义的部位为顶叶脑白质、枕叶脑白质及豆状核、外囊。结论Ⅱ型糖尿病患者在出现认知力改变之前确实存在脑实质微结构改变,弥散峰度成像能够对这一变化进行早期监测。

Objective To monitor early occult cerebric damage by diffusion kurtosis imaging（DKI）in patients with type II diabetes mellitus. Methods A total of 31 patients with type II diabetes mellitus were taken as the case group（TDM）, and 26 age-, sex- and education level-matched healthy people were taken as the normal controls（NC）. All cases received DKI and evaluation of cognition. The mean kurtosis（MK）, the fractional anisotropy（FA） and the mean diffusion（MD） values of different encephalic regions were measured.Results Of the NC group and TDM group, significant differences of MD values（mean MD ＋ SD） were existed in white matter area of occipital lobe, lenticular nucleus, thalamus. Significant differences of MK values（mean MD ＋ SD）were existed in parietal white matter, white matter area of occipital lobe, lenticular nucleus, extra-capsule. But there was no significant difference in FA value between two groups. ConclusionIndividuals with type 2 diabetes showed microstructural abnornxalities in various encephalic region before shows a sign of cognitive abnormal. These abnormalities can be detected earlier by diffusion kurtosis imaging.