心脏磁共振技术评价老年2型糖尿病无并发症患者各冠状动脉区域左心室肌T2~*值定量研究

Quantitative evaluation of myocardium T2~* value in elderly patients with type 2 diabetes mellitus without complications by cardiac magnetic resonance T2~* Mapping sequence

目的 采用心脏磁共振(cardiac magnetic resonance,CMR)定量评价老年2型糖尿病(type2diabetesmellitus,T2DM)无并发症患者各冠状动脉供血区域左心室肌T2*值。方法 前瞻性搜集老年T2DM无并发症患者(年龄≥60岁,17(男7,女10)例、非老年T2DM无并发症患者(年龄<60岁,37(男18,女19)例、以及健康老年对照组(年龄≥60岁,12(男5,女7)例,并记录老年T2DM无并发症患者的糖尿病病程及体质量指数(BMI),采用CMRT2*Mapping序列对上述纳入对象进行左心室短轴位扫描。比较上述3组纳入对象之间左前降支(LAD)、左回旋支(LCX)、右冠状动脉(RCA)供血区域左心室肌T2*值的差异,并分析左心室各冠状动脉供应节段心肌T2*值与糖尿病病程及BMI有无相关性。结果 老年T2DM组LCX供应区域左心室肌T2*值低于健康老年对照组,差异有统计学意义(P<0.05),其余老年T2DM组与非老年T2DM组、健康老年对照组LAD、RCA供血区域左心室肌T2*值差异无统计学意义;老年T2DM无并发症患者左心室肌T2*值与糖尿病病程及BMI无相关性。结论 老年T2DM组LCX供应区域心室肌T2*值降低,提示心肌可能缺血缺氧。

AIM To evaluate the value of left ventricular myocardium T2* in quantitative evaluation of different coronary artery blood supply areas in elderly patients with type 2 diabetes mellitus (T2DM) with no complications. METHODS Prospectively collected for this study were 17 elderly T2DM cases without complications (age ≥ 60 years, 7 males and 10 females), 37 non-elderly T2DM cases without complications (age <60 years, 18 males and 19 females) and healthy elderly 12 volunteers who served as controls (age ≥ 60 years, 5 males and 7 females). T2*Mapping sequence was used to scan their left ventricular short axis and their duration of diabetes and body mass index were recorded. The differences of T2* values of left ventricular myocardium in the left anterior descending artery (LAD), left circumflex artery (LCX) and right coronary artery (RCA) were compared between the above three groups and the correlation of T2* values of the left ventricular coronary artery supply segment and the duration of diabetes and body mass index was analyzed. RESULTS The T2* value of LCX supply ventricular myocardium in elderly T2DM group was lower than that in healthy control group and the difference was statistically significant (P<0.05). There was no significant difference in T2* values between LAD and RCA supply ventricular myocardium in the above three groups (all P>0.05). There was no correlation between T2* value of left ventricular myocardium and the duration of diabetes and body mass index in elderly T2DM patients without complications. CONCLUSION The T2* value of the ventricular myocardium in the left circumflex donor region in elderly T2DM group has decreased, suggesting that the myocardium may be hypoxic.