基于磁共振动脉自旋标记成像的2型糖尿病患者大脑灌注特征网络研究  

Study on cerebral perfusion characteristic network of type 2 diabetes mellitus patients based on MR arterial spin labeling imaging

作　　者：班淇琦 瞿航 王苇[1] 赵义[1] 朱珠 BAN Qiqi;QU Hang;WANG Wei;ZHAO Yi;ZHU Zhu(Department of Medical Imaging,the Affiliated Hospital of Yangzhou University,Yangzhou 225009,China;Graduate School of Dalian Medical University,Dalian 116000,China)

机构地区：[1]扬州大学附属医院影像科,扬州225009 [2]大连医科大学研究生院,大连116000

出　　处：《磁共振成像》2024年第8期73-77,102,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：江苏省2017年高层次卫生人才“六个一工程”拔尖人才项目(编号:LGY2017030)。

摘　　要：目的利用MR动脉自旋标记(arterial spin labeling,ASL)分析2型糖尿病(type 2 diabetes mellitus,T2DM)患者大脑微循环血流灌注及灌注特征模式的改变,并分析这些变化与生化指标间的相关性。材料与方法选取就诊于我院符合T2DM诊断标准的患者28人,健康对照(healthy control,HC)组26人,进行ASL成像,进行基于体素水平的分析及主成分分析,比较两组间大脑血流量(cerebral blood flow,CBF)及灌注特征网络的改变。结果与HC组比较,糖尿病患者两侧中央旁小叶、左侧补充运动区、两侧扣带回中部、左侧岛盖部额下回、左侧颞中回、左侧颞下回等区域的灌注明显较低(P<0.05,GRF多重比较校正)。与疾病相关的两个灌注网络的方差组分占总方差的比率分别为17.6%和11.7%(位于95%置信区间)具有显著性。第一个灌注网络特征表达值与空腹血糖明显正相关(r=0.32,P=0.001),以第二个灌注特征网络为模板提取的糖尿病组CBF与患者空腹血糖负相关(r=0.12,P=0.03)。结论糖尿病患者部分脑区血流灌注降低,基于主成分的灌注特征能够区分T2DM患者与HC,其灌注模式的改变反映了大脑血流灌注的重塑,为糖尿病微血管病变的早期诊断及干预提供了参考依据。Objective:To analyze the cerebral microcirculation blood flow perfusion and perfusion patterns in patients with type 2 diabetes mellitus(T2DM)by using MR arterial spin labeling(ASL),and to analyze the correlation between these changes and biochemical indexes.Materials and Methods:Twenty-eight patients who met our T2DM diagnostic criteria and 26 healthy control(HC)were selected in this study.We conducted ASL,principal component analysis,and calculated the cerebral blood flow(CBF)and perfusion feature network on subjects.Results:Compared with HC group,the perfusion areas including bilateral paracentral lobules,left supplementary motor area,the middle bilateral gyrus cinguli,left opercular part of the inferior frontal gyrus,left middle temporal gyrus,and left inferior temporal gyrus in diabetic patients were significantly lower(P<0.05,GRF adjusted).The ratios of the variance components of the two disease-related perfusion networks to the total variance were 17.6%and 11.7%(95%confidence interval),and they were statistically significant.The first perfusion network characteristic expression value was significantly positively correlated with fasting blood glucose(r=0.32,P=0.001),and the extracted CBF of the diabetic group using the second perfusion characteristic network as a template was negatively correlated with the patient's fasting blood glucose(r=0.12,P=0.03).Conclusions:The diabetic patients had low regional cerebral blood flow.Principal component-based perfusion characteristics can identify patients with diabetes.The changes in perfusion patterns reflected the remodeling of cerebral blood flow perfusion,which had more important value and significance for the early diagnosis and intervention of diabetic microangiopathy.

关 键 词：2型糖尿病 动脉自旋标记 磁共振成像 主成分分析 灌注特征 

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]