增殖期糖尿病视网膜眼病的动态增强MRI初步研究  

Characteristic findings of dynamic contrast enhancement magnetic resonance imaging in proliferative diabetic retinopathy

作　　者：许庆刚[1] 陈青华[1] 鲜军舫[1] 王振常[1] 

机构地区：[1]首都医科大学附属北京同仁医院医学影像中心,北京100730

出　　处：《磁共振成像》2012年第5期347-351,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：北京市卫生系统高层次卫生技术人才基金(编号:2011-2-10)

摘　　要：目的探讨利用MRI技术研究糖尿病视网膜眼病患者在注射对比剂后血-视网膜屏障(BRB)的破坏情况,探讨MRI评价糖尿病视网膜病变的可行性。材料与方法选取增殖期糖尿病视网膜眼病(PDR)患者及其与之年龄相匹配的对照组受试者。PDR患者7例,男3例,女4例,平均年龄为(54±14)岁,糖尿病病史为(9±4)年,共扫描14只眼;对照组受试者14例,男7例,女7例,平均年龄为(50±15)岁,共扫描16只眼。采用动态增强MRI(DCE-MRI)检测受试者活体视网膜BRB的变化情况。用NIHimage软件进行数据分析。视网膜前玻璃体内的信号强度变化用于统计学分析。结果 (1)对照组视网膜前玻璃体区在注射对比剂后时间-信号强度变化的最大斜率的平均值为-0.0457±0.1129。PDR组视网膜前玻璃体内时间-信号强度变化的最大斜率的平均值为0.4393±0.2697,显著高于对照组(P<0.05)。(2)在延迟扫描时相,BRB破坏处可清楚地显示视网膜前区玻璃体腔内高信号的顺磁性对比剂,且随着时间的延长范围逐渐扩大。(3)糖尿病视网膜眼病动态增强曲线示BRB破坏区前方玻璃体内的时间-信号曲线呈持续上升型。结论 DCE-MRI可用于监测糖尿病视网膜病变BRB的破坏情况。视网膜功能MRI具有其独特价值。3.Objective：Magnetic resonance imaging,employing dynamic contrast enhancement MRI（DCE-MRI）,was used to detect changes in blood-retinal barrier（BRB） damage in patients with diabetes,which contributed to diabetic retinopathy and highlighted new information available from such applications.Materials and Methods：Seven participants were proliferative diabetic retinopathy（PDR） who were 3 males,4 females,mean age（54±14） years,mean duration of diabetes（9±4） years and 14 examined eyes,as well as 14 non-diabetic individuals of similar age who were 7 males,7 females,mean age（50±15） years and 16 examined eyes.Images were obtained using a 1.5 T GE scanner system.And after obtaining ophthalmologic data,dynamic contrast enhancement MRI was applied for detecting BRB damage in patients with diabetes.Data were analyzed with NIH IMAGE software.Preretinal vitreous water signals were used for data analysis statistically.Results：（1） The mean of the slope（the enhancement of the MRI signal to the time after contrast injection） in the control group was-0.0457±0.1129.The mean of the slope in PDR group was 0.4393±0.2697,which was significantly higher（P0.05） than the control group.（2） During the delayed scans the BRB leakage demonstrated clearly a gradient of high signal intensity inside the vitreous which spread with time,related to a large diffusion of paramagnetic contrast.（3） The time-intensity curve of dynamic contrast enhancement in the BRB leakage suggested a pattern with sustained enhancement.Conclusion：These results revealed that DCE-MRI can be used to detect BRB damages in diabetic retinopathy.Wide application of this technique for diagnosis and evaluation of treatment efficacy in diabetic retinopathy is expected.

关 键 词：磁共振成像 糖尿病视网膜病变 

分 类 号：R445.2[医药卫生—影像医学与核医学] R774[医药卫生—诊断学]