从宏观解剖到微观分子成像看糖尿病胰腺的可视化技术进展

Progress in visualization technology for diabetic pancreas from macroscopic anatomy to microscopic molecular imaging

胰腺作为分泌胰岛素的器官,随糖尿病(diabetes mellitus,DM)的发生、发展而产生相应病理改变,这其中可能蕴含着DM发病及进展的关键信息。除各种生化指标外,胰腺影像学也提供了反映DM胰腺的相关信息。超声、CT、磁共振及核医学成像技术,分别从胰腺外形、血流动力学信息、分子成像等方面实现非侵入性可视化DM患者胰腺。近年来,基于磁共振及核医学成像的β细胞成像技术取得了重大进展,尤其是利用核素标记胰高血糖素样肽-1受体靶向探针量化胰岛β细胞总数(β-cell mass,BCM)技术已初显成效,为胰岛BCM检测提供了先进的可视化方法。但受限于各类成像技术的应用条件且缺乏临床数据、判读标准和评估方法等,目前临床上仍无准确有效且安全性高的特异性评估DM胰腺成像方法。本文详细阐述了DM胰腺可视化技术的研究进展,以期为开发评估DM患者胰腺影像学工具提供参考。

As the insulin-secreting organ,pancreas will appear a series of pathological changes with the occurrence and development of diabetes mellitus(DM),which may provide critical information about the onset and progression of DM.In addition to various kinds of biochemical indicators,pancreatic imaging techniques also provide relevant information reflecting pancreas of DM patients.Ultrasound,computed tomography,magnetic resonance imaging,and nuclear medicine imaging are applied to noninvasively visualize the pancreas of diabetic patients from the aspects of pancreatic appearance,hemodynamic information and molecular imaging.In recent years,theβ-cell imaging technology,based mainly on magnetic resonance imaging and nuclear medical imaging techniques,has achieved significant progress.In particular,the technique of quantifying isletβ-cell mass(BCM)by using radionuclide labeled glucagon-like peptide-1 receptor targeting probe has achieved remarkable results,offering novel visualization methods for islet BCM detection.However,due to the application conditions of various imaging techniques and the lack of relevant clinical data,effective and reliable interpretation standards and evaluation methods,there is still no accurate,effective and safe specific evaluation method for DM pancreas imaging in clinic.This paper elaborates the progress of pancreatic visualization technology in DM,so as to provide reference for the development of pancreatic imaging tools in patients with DM.