基于DKI技术对高血压合并2型糖尿病患者脑部磁共振成像研究  

Study of brain magnetic resonance imaging in patients with hypertension and type 2 diabetes mellitus based on DKI technology

作　　者：杨杰华[1] 杨忠现 陈纯娟[3] 吴焕泽 陈薇[1] 朱志宏[4] YANG Jiehua;YANG Zhongxian;CHEN Chunjuan;WU Huanze;CHEN Wei;ZHU Zhihong(Department of Neurology,the Second Affiliated Hospital,Medical Academy of Shantou University,Shantou 515041,China;Department of Medical Imaging Center,Shenzhen Hospital of Southern Medical University,Shenzhen,518000,China;Department of Cardiology,the Second Affiliated Hospital,Medical Academy of Shantou University,Shantou 515041,China;Department of Endocrinology,the Second Affiliated Hospital,Medical Academy of Shantou University,Shantou 515041,China)

机构地区：[1]汕头大学医学院第二附属医院神经内科,汕头515041 [2]南方医科大学深圳医院医学影像中心,深圳518000 [3]汕头大学医学院第二附属医院心血管内科,汕头515041 [4]汕头大学医学院第二附属医院内分泌科,汕头515041

出　　处：《磁共振成像》2021年第7期1-5,17,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：广东省医学科学技术研究基金项目(编号:A2019278)。

摘　　要：目的应用扩散峰度成像(diffusion kurtosis imaging,DKI)技术检测高血压合并2型糖尿病(type 2 diabetes mellitus,T2DM)患者的早期亚临床脑细胞损害。材料与方法选取无神经系统功能缺损的高血压合并T2DM患者26例及性别、年龄、受教育程度匹配的单纯高血压患者27例、健康体检者16例,对三组行头颅MRI、DKI检查,测定双侧海马回、半卵圆中心、尾状核头部、内囊后肢、丘脑、红核、黑质、桥脑、小脑的平均峰度(mean kurtosis,MK)值、平均扩散系数(mean diffusivity,MD)值、部分各向异性(fractional anisotropy,FA)值。结果MK值在左海马回、左半卵圆中心、双侧尾状核头部、左内囊后肢三组间两两比较差异有统计学意义(P<0.05或P<0.01),MK值在双侧丘脑、左黑质三组间两两比较部分组间差异有统计学意义(P<0.05或P<0.01)。MD值在右侧丘脑三组间两两比较差异有统计学意义(P<0.05或P<0.01),MD值在右尾状核头三组间两两比较部分组间差异有统计学意义(P<0.05或P<0.01)。FA值在左内囊后肢三组间两两比较差异有统计学意义(P<0.05或P<0.01),FA值在左半卵圆中心、右内囊后肢三组间两两比较部分组间差异有统计学意义(P<0.05或P<0.01)。结论高血压合并T2DM患者在海马回、半卵圆中心、尾状核头部、内囊后肢、丘脑、黑质的脑细胞已有损害,且比单纯高血压患者损害更加严重。Objective:To evaluate the early subclinical brain cell damage in patients with hypertension and type 2 diabetes mellitus(T2DM)by diffusion kurtosis imaging(DKI).Materials and Methods:Twenty-six patients with hypertension and T2DM without neurological function and cognitive impairment,27 patients with simple hypertension and 16 healthy subjects matched with gender,age and education level,were enrolled in this study,brain MRI and DKI were performed in three groups.The mean kurtosis(MK),mean diffusivity(MD)and fractional anisotropy(FA)of bilateral hippocampal gyrus,centrum semiovale,caudate head,posterior limb of internal capsule,thalamus,red nucleus,substantia nigra,pons and cerebellum were measured.Results:There were significant differences in MK values of left hippocampus gyrus,left centrum semiovale,bilateral caudate head and left posterior limb of internal capsule between three groups(P<0.05 or P<0.01),and there were significant differences in MK values of bilateral thalamus and left substantia nigra between some groups(P<0.05 or P<0.01).MD value in the right thalamus was significantly different between the three groups(P<0.05 or P<0.01),MD value in the right caudate head was significantly different between the some groups(P<0.05 or P<0.01).There was significant difference in FA value of left posterior limb of internal capsule between the three groups(P<0.05 or P<0.01),and there were significant difference in FA values of left centrum semiovale,right posterior limb of internal capsule between the some groups(P<0.05 or P<0.01).Conclusions:The brain cell of hippocampus gyrus,centrum semiovale,caudate head,posterior limb of internal capsule,thalamus and substantia nigra has been damaged in patients with hypertension and T2 DM,and the damage was more serious than that in patients with simple hypertension.

关 键 词：高血压合并2型糖尿病 原发性高血压 磁共振成像 扩散峰度成像 亚临床脑细胞损害 

分 类 号：R445.2[医药卫生—影像医学与核医学] R587.1[医药卫生—诊断学]