2型糖尿病患者脑部小血管病变的MRI评价  

MRI features of cerebral small vessel disease in patients with type 2 diabetes mellitus

作　　者：肖正光[1] 杨军[1] 朱才松[1] 邵康为[1] 袁立新[1] 闵庆华[1] 顾峰[1] 陆文杰[1] 

机构地区：[1]上海市同仁医院上海交通大学医学院附属同仁医院影像科,上海200336

出　　处：《中国临床医学影像杂志》2016年第5期318-322,共5页Journal of China Clinic Medical Imaging

基　　金：上海市重点专科建设科研基金资助(No.05II025)

摘　　要：目的 ：本研究应用多种磁共振技术,对2型糖尿病人的脑部小血管损害表现进行无创评估,以期对临床糖尿病的诊治及评估给予一定的帮助。材料和方法：收集2013年1—12月我院神经内科住院患者437例,排除18例,分为糖尿病组和无糖尿病组,应用3.0T磁共振扫描仪,行颅脑轴位T1WI、T2WI、FLAIR、DWI、SWI、矢状面T_2加权像序列扫描,分别记录各个病例急性梗塞的发生例数及分布类型、脑内微出血灶、腔隙性梗塞灶的发生数目,脑白质疏松程度。结果：糖尿病组小血管闭塞型梗塞发生率68.2%（30/44）大于无糖尿病组43.2%（35/81）,差异有统计学意义（χ^2=7.49,P〈0.05）。糖尿病组既往卒中发生率、腔隙灶发生严重程度、脑白质疏松程度均较无糖尿病组严重（P〈0.05）,但脑内微出血的发生程度两组无差异（P〉0.05）。结论：2型糖尿病患者急性梗塞以小病灶为主,其腔隙灶发生严重程度、脑白质疏松程度均较无糖尿病组严重。Objective： To evaluate the manifestation of cerebral small vessel damage of type 2 diabetes using noninvasive techniques of MR imaging, and to provide useful information for clinical diagnosis, therapy, and long term evaluation of diabetes. Materials and Methods： Four hundred and thirty-seven neurology inpatients were recruited in our study between January 2013 and December 2013, eighteen cases were excluded. Diabetes group and non-diabetes group were observed. All patients underwent brain MRI with T1 WI, T2 WI, FLAIR, DWI, SWI and T-2 WI sequences in 3.0T scanner. The incidence rate and distribution pattern of acute infarction, cerebral micro hemorrhage, the number of lacunar infarction and the degree of leukoaraiosis were recorded. Results： The incidence rate of infarction caused by small vessel occlusion was higher in diabetes group than in non-diabetes group（68.2% vs 43.2%）. There was statistical difference between diabetes group and non-diabetes group（χ^2=7.49, P〈 0.05）. Compared with non-diabetes, diabetes group showed up more serious degree in previous cerebral apoplexy, lacunar infarction and leukoaraiosis. There was no statistical difference in the occurrence rate of cerebral micro-hemorrhage between the two groups（P〉0.05）. Conclusion： Small lesions was mainly presented in acute infarction happened in patients with type 2 diabetes. The severity of lacunar infarction and leukoaraiosis occurred in diabetes group was severer than that in non-diabetes group.

关 键 词：糖尿病 2型 糖尿病血管病变 脑血管障碍 磁共振成像 

分 类 号：R643[医药卫生—外科学] R445.2[医药卫生—临床医学]