3D-pCASL对无认知障碍2型糖尿病患者全脑血流的初步研究  

A preliminary study on the whole cerebral blood flow in patients with type 2 diabetes mellitus without cognitive impairment by 3D-pCASL

作　　者：王振松[1] 张爱英 魏巍巍[1] 刘建宪[1] 甘洁[1] 尹爱群[1] 李涛[1] WANG Zhensong;ZHANG Aiying;WEI Weiwei;LIU Jianxian;GAN Jie;YIN Aiqun;LI Tao(Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250002,P.R.China;Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250002,P.R.China)

机构地区：[1]山东中医药大学第二附属医院放射科,山东济南250012 [2]山东中医药大学附属眼科医院,山东济南250002

出　　处：《医学影像学杂志》2019年第7期1081-1084,共4页Journal of Medical Imaging

摘　　要：目的利用3D-pCASL(three-dimensional pseudo continuous arterial spin labeling,3D-pCASL)技术探测无认知障碍2型糖尿病患者脑血流(cerebral blood flow,CBF)的改变。方法2型糖尿病患(Type 2 Diabetes Mellitus,T2DM)者23例,年龄、性别相匹配的健康对照组(healthy controls,HCs)24例。患者组及对照组均由神经专科医师行简易精神状态量表(mini mental state examination,MMSE)评分。MRI检查前,行空腹血糖及糖化血红蛋白实验室检查;MR检查序列包括:3D-pCASL、常规MR序列检查(T1Flair、T2WI、T2-FLAIR、DWI,以除外脑血管病、肿瘤等器质性病变)。MR检查结束后,应用GE-ADW4.6工作站将3D-pCASL序列进行后处理,得到相应脑血流(cerebral blood flow,CBF)图;应用基于Matlab的SPM、Dpabi软件对CBF图进行标准化处、归一化、平滑化处理,之后应用全脑MASK模板提取脑CBF值;应用SSPS 17.0对T2DM、HCs组CBF数据进行统计学处理,并对T2DM患者组CBF与血糖(Blood Glucose,Glu)值、糖化血红蛋白(GlycatedHemoglobin,HbA1c)值行Spearman相关性分析。结果T2DM、HCs组CBF全脑CBF值存在统计学差异(P=0.033);T2DM组CBF值与病史时间(P=0.491,r=0.19)、Glu值(P=0.958,r=-0.14)、HbA1c值(P=0.312,r=-0.27)、血压(P=0.307,r=-0.28)无相关性。结论3D-pCASL技术可客观评价T2DM患者CBF改变,为临床进行早期干预提供参考信息。Objective To explore the changes of cerebral blood flow(CBF)in type 2 diabetic patients without cognitive impairment by using three-dimensional ASL(Three-Dimension Arterial Spin Labeling)technique.Methods 23 patients with type 2 diabetes mellitus(T2 DM)and 24 healthy controls(HCs)matched by age and sex were included.Mini Mental State Examination(MMSE)was scored by neurologists in both the patient group and the control group.Before MRI examination,fasting blood glucose and glycosylated hemoglobin were examined in laboratory.MR sequences included 3 D-pCASL,conventional MR sequence(T1Flair,T2WI,T2-FLAIR,DWI,excluding cerebrovascular diseases,tumors and other organic lesions).After MR examination,the 3 D-pCASL sequence was processed by GE-ADW4.6 workstation,and the corresponding cerebral blood flow(CBF)map was obtained.The SPM and Dpabi software based on MATLAB were used to standardize,normalize and smooth CBF maps,and then the whole brain MASK template was used to extract brain CBF values.The CBF data of T2 DM and HCs groups were analyzed by SSPS 17.0 with independent sample T test.The correlation between CBF and blood glucose(Glu),glycosylated hemoglobin(HbA1 c)and medical history was analyzed by Spearman.Results There were significant differences in CBF values of whole brain between T2 DM and HCs groups(P=0.033).There was no correlation between CBF values of T2 DM group and history time(P=0.491,r=0.186),Glu values(P=0.958,r=-0.14),HbA1 c values(P=0.312,r=-0.27).Conclusion 3 D-pCASL technology can objectively evaluate CBF changes in patients with T2 DM,and provide reference information for early clinical intervention.

关 键 词：2型糖尿病 磁共振成像 脑血流 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]