基于MRI动脉自旋标记技术研究2型糖尿病脑血流量变化及其与认知功能的关系  

Cerebral blood flow changes in type 2 diabetes mellitus and its relationship with cognitive function based on MR Iarterial spinlabeling technique

作　　者：陈羽娜 李赛美[1] 李卉英 邱士军[1] Chen Yuna;Li Saimei;Li Huiying;Qiu Shijun(Department of Radiology,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Department of Encephalopathy,Yanbian Hospital of Traditional Chinese Medicine,Yanji Hospital of Traditional Chinese Medicine,Yanbian 133000,China)

机构地区：[1]广州中医药大学第一附属医院影像科,广州510405 [2]延边中医医院延吉市中医医院脑病科,延边133000

出　　处：《中华放射学杂志》2025年第1期77-83,共7页Chinese Journal of Radiology

基　　金：国家自然科学基金(82330058、T2341014);中国博士后科学基金第16批特别资助(站中)(2023T160149);国家中医药传承创新中心科研专项(青年项目)(2023QN09)。

摘　　要：目的采用动脉自旋标记(ASL)技术探讨2型糖尿病(T2DM)脑血流量(CBF)的变化及其与认知功能的关系。方法该研究为横断面研究。回顾性分析2017年9月至2019年3月在广州中医药大学第一附属医院就诊的46例T2DM患者(T2DM组)以及57名健康对照组(HC组)的临床资料(年龄、性别、受教育年限、体重指数)及影像学资料。所有受试者均接受临床认知功能量表评估,包括听觉词语学习测试(AVLT)、连线测试(TMT)、蒙特利尔认知评估量表(MoCA)等,并接受常规全脑斜轴位3D-ASL成像。通过对3D-ASL原始图像进行处理,自动生成CBF伪彩图,提取差异脑区的CBF值。采用独立样本t检验、Mann-Whitney U检验、χ^(2)检验评估T2DM组与HC组临床资料、认知功能量表评分及CBF值的差异。采用偏相关分析方法,控制年龄、性别、受教育年限,分析差异脑区CBF值与认知功能量表评分的相关性。结果T2DM组与HC组的年龄、性别、受教育年限、AVLT评分、TMT评分差异均无统计学意义(P>0.05),体重指数、MoCA评分差异均有统计学意义(Z=-2.16,P=0.031;Z=-3.18,P=0.001)。与HC组相比,T2DM组左侧岛叶CBF显著增加(P<0.001),而右侧梭状回、右侧楔前叶及右侧前额叶CBF显著降低(P<0.001)。偏相关分析显示,T2DM组右侧前额叶CBF值与MoCA评分(r=0.330,P=0.001)呈正相关,右侧梭状回CBF值与MoCA评分(r=0.210,P=0.034)呈正相关。结论T2DM患者在左侧岛叶、右侧梭状回、右侧楔前叶及右侧前额叶CBF存在改变,且右侧前额叶及右侧梭状回CBF降低与认知功能下降有关。ObjectiveTo investigate cerebral blood flow(CBF)changes in type 2 diabetes mellitus(T2DM)and its relationship with cognitive function by arterial spin labeling(ASL).MethodsThis study was a cross-sectional study.Clinical data(age,sex,years of education,body mass index)and imaging data of 46 patients with T2DM(T2DM group)and 57 healthy controls(HC group),who visited the First Affiliated Hospital of Guangzhou University of Chinese Medicine from September 2017 to March 2019 were analyzed retrospectively.All subjects underwent clinical cognitive function assessments,including the auditory verbal learning test(AVLT),trail making test(TMT),and montreal cognitive assessment(MoCA)scale.All subjects underwent routine axial 3D-ASL imaging,and CBF pseudocolor images were automatically generated from the 3D-ASL raw images.CBF values in the differential brain regions were extracted.The differences in clinical data,cognitive function scores,and CBF values between T2DM group and HC group were evaluated using independent sample t-tests,Mann-Whitney U tests,andχ^(2) tests.The correlation between the differential brain region CBF values and cognitive function scores was analyzed using partial correlation analysis,controlling for age,gender,and years of education.ResultsThere were no significant differences in age,gender,years of education,AVLT scores,and TMT scores between T2DM group and HC group(P>0.05).But there were significant differences in body mass index and MoCA scores(Z=-2.16,P=0.031;Z=-3.18,P=0.001).Compared with HC group,T2DM group showed significantly increased CBF in the left insula(P<0.001),but significantly decreased CBF in the right fusiform gyrus,right cuneus,and right prefrontal gyrus(P<0.001).The partial correlation analysis showed that the CBF value in the right prefrontal gyrus of T2DM group was positively correlated with MoCA scores(r=0.330,P=0.001),while the CBF value in the right fusiform gyrus was positively correlated with MoCA scores(r=0.210,P=0.034).ConclusionsPatients with T2DM show changes in CBF in t

关 键 词：磁共振成像 糖尿病 2型 脑血流量 认知功能 

分 类 号：R74[医药卫生—神经病学与精神病学]