多模态MRI成像对2型糖尿病轻度认知功能障碍患者胼胝体的评估  

Evaluation of corpus callosum in type 2 diabetic patients with mild cognitive impairment by multimodal MRI

作　　者：仲乐乐 孙庆闻 张培 吴晓 张喜友[2] 董洋[2] 张策[3] 张炜炜 林永忠[1] 张依娜 刘莹[1] Zhong Lele;Sun Qingwen;Zhang Pei;Wu Xiao;Zhang Xiyou;Dong Yang;Zhang Ce;Zhang Weiwei;Lin Yongzhong;Zhang Yina;Liu Ying(Department of Neurology,Second Hospital Affiliated of Dalian Medical University,Dalian,116000,China)

机构地区：[1]大连医科大学附属第二医院神经内科 [2]大连医科大学附属第二医院影像科 [3]大连医科大学附属第二医院药学部 [4]大连医科大学附属第二医院内分泌科 [5]江苏省南京脑科医院重症医学科 [6]北部战区总医院神经内科

出　　处：《中国中西医结合影像学杂志》2019年第6期556-561,共6页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：大连市医学科学研究计划项目(1712037)

摘　　要：目的:应用多模态MRI成像(1 H-MRS及DTI),探讨糖尿病轻度认知功能障碍(MCI)患者胼胝体的影像改变及其与认知功能的关系。方法:选取糖尿病MCI患者10例为MCI组,另选取健康志愿者10例为对照组。检测2组空腹血糖及糖化血红蛋白(HbAlc)水平;采用蒙特利尔认知评估量表(MoCA)、简易精神状态量表(MMSE)进行认知功能评估;应用1 H-MRS、DTI技术扫描胼胝体区,检测N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)浓度,计算NAA/Cr、Cho/Cr比值,测定各向异性分数(FA)、ADC值,分析2组参数差异及其与空腹血糖、HbAlc、认知功能评分的相关性。结果:与对照组比较,MCI组胼胝体压部NAA、NAA/Cr、Cho/Cr均降低(均P<0.05),膝部NAA、Cho、Cho/Cr均降低(均P<0.05),压部、膝部FA值降低、ADC值升高(均P<0.05)。MCI组胼胝体压部NAA、NAA/Cr、Cho/Cr、FA值与空腹血糖、HbAlc浓度、糖尿病病程均呈负相关(均P<0.05),压部ADC值与HbAlc浓度、糖尿病病程均呈正相关(均P<0.05)。膝部NAA、Cho、Cho/Cr、FA值与空腹血糖、HbAlc浓度、糖尿病病程均呈负相关(均P<0.05),膝部ADC值与空腹血糖、HbAlc浓度、糖尿病病程均呈正相关(均P<0.05)。压部NAA、NAA/Cr及膝部NAA、Cho与MoCA评分均呈正相关(均P<0.05)。压部、膝部FA值与MoCA评分均呈正相关(P<0.05)。膝部FA值与MMSE评分呈正相关(P<0.05)。结论:2型糖尿病MCI患者胼胝体区存在代谢及白质微观结构改变,且上述改变与空腹血糖、HbAlc浓度、糖尿病病程、MoCA评分相关。MoCA量表结合胼胝体区1 H-MRS及DTI参数改变有助于早期认识和解释糖尿病患者认知功能的损害。Objective:In this study,multi-mode MRI(1 H-MRS and DTI)was used to investigate the changes of corpus callosum image and its relationship with cognitive function in diabetic patients with mild cognitive impairment(MCI).Methods:Ten dia betic patients with MCI(MCI group)and 10 healthy controls(control group)were recruited.Fasting venous blood was extract ed and fasting blood glucose and glycosylated hemoglobin were detected.MoCA and MMSE scales were used to evaluate cogni tive function.1 H-MRS was used to scan the corpus callosum area,NAA,Cho and Cr concentrations were collected,NAA/Cr and Cho/Cr ratios were calculated,and DTI was used to scan the corpus callosum area,FA and ADC values were determined.The differences in functional magnetic resonance parameters between MCI group and control group and their correlation with fasting blood glucose,glycogenated hemoglobin and cognitive function scores were analyzed.Results:Compared with the control group,NAA,NAA/Cr and Cho/Cr in the splenium of corpus callosum decreased in MCI group(P<0.05),NAA,Cho,Cho/Cr in the genu of corpus callosum decreased(P<0.05),FA value in the splenium and genu of corpus callosum decreased,while ADC value increased(P<0.05).NAA,NAA/Cr,Cho/Cr and FA value of corpus callosum splenium were negatively correlated with fasting blood glucose,glycosylated hemoglobin concentration and diabetes course,while ADC of corpus callosum splenium was positively correlated with glycosylated hemoglobin concentration and diabetes course(P<0.05).The values of NAA,Cho,Cho/Cr and FA in the genu of corpus callosum were negatively correlated with fasting blood glucose,glycogenated hemoglobin concentration and the course of diabetes mellitus,while ADC of corpus callosum genu was positively correlated with fasting blood glucose,glycosy lated hemoglobin concentration and diabetes course(P<0.05).NAA,NAA/Cr in the splenium of corpus callosum and NAA and Cho in the genu of corpus callosum were positively correlated with MoCA score(P<0.05).FA value of corpus callosum sple nium a

关 键 词：糖尿病 2型 认知障碍 胼胝体 磁共振成像 

分 类 号：R74[医药卫生—神经病学与精神病学]