2型糖尿病患者脑部皮层下白质及胼胝体体积定量分析  

Changes in Subcortical White Matter and Corpus Callosum Volumes in Patients with Type Ⅱ Diabetes Mellitus

作　　者：陈志晔[1] 李金锋[1] 孙杰[1] 马林[1] 

机构地区：[1]中国人民解放军总医院放射科,北京100853

出　　处：《中国医学科学院学报》2013年第5期503-514,共12页Acta Academiae Medicinae Sinicae

基　　金：国家自然科学基金(81171319);中国人民解放军总医院科技创新苗圃基金(13KMM41)~~

摘　　要：目的探讨2型糖尿病患者皮层下白质及胼胝体体积变化,以及胰岛素治疗对其影响。方法对16例2型糖尿病患者及16名健康志愿者进行脑形态学分析,其中11例2型糖尿病患者进行基线(胰岛素治疗前)及随访水平(胰岛素治疗1年)的体积测量。统计学方法采用协方差分析及配对t检验。结果 2型糖尿病患者双侧额中回尾侧、双侧额叶岛盖部、右侧顶下回、右侧颞下回、右侧颞中回及左侧颞横回皮层下白质体积较正常对照组显著减小(P<0.05),胰岛素治疗1年后左侧内侧额叶眶回、右侧额中回吻侧、右侧顶下回、右侧舌回、右侧颞下回、右侧颞中回、左侧颞横回、左侧内嗅皮层及右侧岛叶皮层下白质体积较基线水平显著增加(P<0.05),双侧中央旁回、右侧额上回、右侧楔前叶皮层下白质体积较对照组显著减少(P<0.05)。2型糖尿病患者胼胝体体积较对照组呈减低趋势(P>0.05),胰岛素治疗后胼胝体中后部体积显著减小(P<0.05)。结论 2型糖尿病患者脑部损害可以表现为多个脑区皮层下白质体积减少,胰岛素治疗有助于改善脑部皮层下白质体积萎缩。皮层下白质体积分析可以用来有效评估2型糖尿病患者脑部白质损害。Objective To evaluate the changes in subcortical white matter and corpus callosum volumes in patients with type II diabetes mellitus （T2DM）. Methods High resolution three-dimensional Tl-weighted fast spoiled gradient recalled echo magnetic resonance images were obtained from 16 T2DM patients and 16 normal con- trois, and 11 T2DM patients also received the same magnetic resonance imaging scans after insulin therapy for 1 year. Volumetric analysis was performed and analysis of covariance and paired t test were applied. Results A lower volume was demonstrated in T2DM patients than that in the normal controls in bilateral caudal middle frontal lobe, bilateral pars opereularis, right inferior parietal lobe, right inferior temporal lobe, right middle temporal lobe, and left transverse temporal lobe （ all P 〈 0. 05 ） . After insulin therapy for 1 year, the increased subcorti- cal white matter of brain regions were demonstrated in left medial orbitofrontal lobe, right caudal middle frontal lobe, right inferior parietal lobe, fight lingual lobe, right inferior temporal lobe, fight middle temporal lobe,left transverse temporal lobe, left entorhinal lobe and left insular lobe at the follow-up level in T2DM patients compared with baseline level （P 〈 0. 05 ） . The decreased volumes of subcortical white matter were observed in the bilateral paracentral lobe, right superior forntal lobe and right precuneus lobe in T2DM patients on insulin therapy for 1 year （P 〈 0. 05 ） . A decreased trend of subcortical white matter was involved in corpus callosum （ P 〉 0. 05 ） and a significant decreased volume was demonstrated in the middle posterior part of corpus callosum after insulin therapy for 1 year （ P 〈 0. 05 ） . Conclusions T2DM patients have decreased subcortical white matter of multiple brain regions, and the atrophy of subcortical white matter can be improved by the insulin thera- py. The volume analysis of subcortical white matter is a simple and effective tool for the evaluation of white matte

关 键 词：2型糖尿病 脑 磁共振 白质 胼胝体 

分 类 号：R445.2[医药卫生—影像医学与核医学]