2型糖尿病伴轻度认知障碍患者丘脑扩散峰度成像研究

Diffusion Kurtosis Imaging Study of Thalamus in Type 2 Diabetes Mellitus Patients with Mild Cognitive Impairment

目的采用扩散峰度成像(DKI)研究2型糖尿病伴轻度认知障碍(T2DM-MCI)患者丘脑微结构变化特点,并探讨DKI在T2DM-MCI诊断中的价值。方法纳入T2DM-MCI组19例、认知正常组(T2DM-NC)21例,以及健康对照组(HC)20例。对所有人员行DKI扫描。经DKE软件生成平均峰度(MK)、轴向峰度(AK)、径向峰度(RK)、各向异性分数(FA)、平均扩散率(MD)参数图,再提取双侧丘脑各参数均值,比较各参数的组间差异。通过受试者工作特征曲线(ROC)寻求诊断T2DM患者MCI的最佳参数和最佳阈值。结果与HC组比较,T2DM组MK、AK、RK、FA均降低,MD均升高,差异有统计学意义(P<0.05)。与T2DM-NC比较,T2DM-MCI组MK值下降11.43%,MD值升高8.26%,差异有统计学意义(P<0.05)。ROC曲线显示,MK的诊断T2DM-MCI效能高于MD。结论DKI技术可显示T2DM患者丘脑存在微结构损害,MK、MD对T2DM患者MCI的早期诊断有一定参考价值。

Objective To study the characteristics of thalamic microstructural changes in type 2 diabetes mellitus patients with cognitive impairment(T2DM-MCI)useing diffusion kurtosis imaging(DKI),and to explore the value of DKI in the diagnosis of T2DM-MCI.Methods 19 cases in T2DM-MCI group,21 cases in normal cognition group(T2DM-NC)and 20 cases in healthy control group(HC)were enrolled in the study.All cases were scanned with DKI.DKE software is used to generate the parameter maps of mean kurtosis(MK),axial kurtosis(AK),radial kurtosis(RK),anisotropy fraction(FA)and mean diffusivity(MD).Then the mean values of parameters in bilateral thalamus are extracted,and the inter group differences of mean values of parameters are compared.Receiver operating characteristic(ROC)test were used to find the optimal parameters and threshold for diagnosing MCI in T2DM patients.Results Compared with HC group,MK,AK,RK and FA decreased and MD increased in T2DM group(P<0.05).Compared with T2DM-NC,the MK value of bilateral thalamus in T2DM-MCI group decreased by 11.43%,and the MD value increased by 8.26%(P<0.05).ROC curve analysis showed that MK was more effective than MD in diagnosing T2DM-MCI.Conclusion DKI technology can show the microstructure damage of thalamus in T2DM patients.MK and MD have a certain reference value for the early diagnosis of MCI in T2DM patients.