醋甲唑胺负荷MR灌注成像对糖尿病患者脑血管储备功能的初步研究  

The Preliminary Study of Cerebrovascular Reserve of Patients with Diabetes By Combining MR Perfusion weighted Imaging with an Methazolamide Challenge

作　　者：金新安[1] 陈伟[1] 马壮[1] 张煜[2] 黄波涛[1] 

机构地区：[1]广东医学院附属厚街医院放射科,523945 [2]广东医学院附属厚街医院内分泌科,523945

出　　处：《临床放射学杂志》2014年第3期339-342,共4页Journal of Clinical Radiology

基　　金：东莞市2011年科研立项(编号:201110515000245)

摘　　要：目的探讨用MR灌注成像结合醋甲唑胺负荷试验评估糖尿病患者的脑血管储备功能（CVR）。方法对80例糖尿病患者和10例正常人在口服醋甲唑胺前后进行2次检查，选取双侧尾状核头部、豆状核、丘脑、额上回、颞上回及楔叶作为兴趣区（ROD，测量的参数包括局部脑血容量（rCBV）和平均通过时间（rMTY）。根据公式局部脑血流量（rCBF）=rCBV／rMTT和CVR（％）：（服药后rCBF-服药前rCBF）／服药前rCBF×100％，计算CVR。结果（1）糖尿病组各ROI的rMTT、rCBV和rCBF在醋甲唑胺负荷前后无统计学意义（P〉0．05）；对照组各ROI的rMTT在醋甲唑胺负荷后缩短（P〈0．05），rCBV和rCBF在醋甲唑胺负荷后增加（P〈0．05）；（2）糖尿病组的CVR较对照组的CVR明显降低（P〈0．05）；（3）病程〉10年的糖尿病患者的CVR较病程〈10年的CVR明显降低（P〈0．05）；（4）糖尿病组中，视网膜正常组、合并视网膜病变Ⅰ-Ⅲ期组、合并视网膜病变Ⅳ～Ⅵ期组，CVR依次降低（P〈0．05）；（5）糖尿病组中高血压组较血压正常组CVR降低（P〈0．05）。结论糖尿病患者的CVR较同年龄组正常人下降，处于亚临床缺血的状态，病程〉10年者和合并视网膜病变、高血压者，CVR下降更明显。Objective To evaluate the cerebrovascular reserve （CVR） of patients with diabetes by MR perfusion weighted imaging （PWI） with an methazolamide challenge. Methods A pair of MR PWI were performed before and after oral administration of methazolamide on 80 patients with diabetes and 10 normal controls. The regions of intrest （ROI） were selected on bilateral caput nuclei caudate, lenticular, thalamus, super frontal gyrus, super tempogyrus and cuneus symmetrically. The region cerebral blood volume （rCBV） and region mean transit time （rMTT） of ROIS were measured. The region cerebral blood flow （rCBF） and CVR was calculated by the formula,rCBF = rCBV/ rMTY, CVR （%） =[（methazolamide challenge rCBF-resting rCBF）/resting rCBF]100%. Results （ 1 ） No significant differences of rMTT, rCBV and rCBF were observed in patients with diabetes before and after methazolamide challenge. The rMTT was significantly （P 〈 0.05 ） decreased while rCBV, rCBF were significantly （ P 〈 0.05 ） increased in controls before and after methazolamide challenge. （2） The CVR of diabetes group was significantly decreased compared to the controls （ P 〈 0.05 ）. （ 3 ） In diabetes group, the CVR of diabetes duration more than 10 years was significantly （P 〈 0.05 ） decreased compared to those less than 10 years. （4） In diabetes group, CVR decreased in order in normal retinal group, groups combined with retinal lesions of I to Ⅲ and groups combined with retinal lesions of Ⅳ to Ⅵ. （5） In diabetes group, the CVR of patients combined with hypertension was significantly （ P 〈 0.05 ） decreased compared to patients without hypertension. Conclusion The CVR of diabetes decrease compared to the healthy group, and furthermore, diabetes with more than 10 years, and combined with retinal lesions or hypertension, CVR decrease more obviously.

关 键 词：磁共振 灌注成像 醋甲唑胺 脑血管储备功能 糖尿病 

分 类 号：R587.1[医药卫生—内分泌] R445.2[医药卫生—内科学]