糖尿病相关认知功能障碍患者颅脑MRI结构和功能特征分析  

Analysis of the structural and functional features of brain MRI in patients with diabetes-related cognitive dysfunction

作　　者：梁飞 王佳伟 徐倩[1] LIANG Fei;WANG Jiawei;XU Qian(Department of Medical Imaging,General Hospital of North China Petroleum Administration Bureau,Cangzhou 062552,China)

机构地区：[1]华北石油管理局总医院医学影像科,河北沧州062552

出　　处：《医学影像学杂志》2025年第2期1-5,共5页Journal of Medical Imaging

基　　金：河北省医学科学研究课题计划项目(编号:20231283)。

摘　　要：目的探讨糖尿病相关认知功能障碍患者颅脑MRI结构和功能特征。方法选取本院就诊的2型糖尿病(T2DM)患者为观察对象,根据是否存在轻度认知功能障碍(MCI)分为合并MCI患者(T2DM-MCI组)60例和认知正常的T2DM组患者60例,同时纳入健康体检的60例作为对照组。对观察对象进行颅脑MRI检查,神经心理学量表测试[简易智能精神状态评估表(MMSE)、蒙特利尔认知评估量表(MoCA)、听觉语言学习测验(AVLT)、数字广度测试(DST)、言语流畅测验(VFT)及连线测试(TMT)]。对比三组认知功能、颅脑MRI结构和功能特征。结果各种神经心理学量表评估的认知功能显示,相较于对照组和T2DM组,T2DM-MCI组表现更差,差异有统计学意义(P<0.05);三组脑白质总体积对比差异无统计学意义(P>0.05),T2DM-MCI组脑灰质总体积较T2DM组、对照组减少,且T2DM组较对照组减少,差异有统计学意义(P<0.05);MRI显示与对照组相比,T2DM组颞上回、颞中回、梭状回、额上回、内侧额叶、楔前叶区域显示灰质体积显著减少,T2DM-MCI组除上述脑区外有更加广泛的脑灰质体积萎缩,并且在海马、海马旁回、杏仁核和钩回边缘系统出现灰质体积的下降。与T2DM组相比,T2DM-MCI组仅在左侧颞中回灰质体积显著减少,差异有统计学意义(P<0.05)。结论糖尿病相关认知功能障碍患者可见脑灰质萎缩,其中颞中回的萎缩程度可能反映了认知损害的严重程度。Objective To investigate the structural and functional features of brain MRI in patients with diabetes-related cognitive dysfunction.Methods Patients with type 2 diabetes mellitus(T2DM)in our hospital were selected as the study subjects.According to the existence of cognitive impairment,the patients were divided into T2DM-MCI group,with 60 patients with MCI,and normal cognition group,with 60 patients.And 60 patients with healthy physical examination were included as the control group.Brain magnetic resonance imaging(MRI)and neuropsychological scale tests(Abbreviated Intelligent Mental State Assessment Form(MMSE),Montreal Cognitive Assessment Scale(MoCA),Auditory Language Learning Test(AVLT),Digital Breadth Test(DST),Verbal Fluency Test(VFT),and Connection test(TMT))were performed.The cognitive function,brain MRI structure and functional features of the three groups were compared.Results Cognitive function assessed by various neuropsychological scales showed that T2DM-MCI group had worse performance than control group and T2DM group(P<0.05).There was no significant difference in the total volume of white matter between the three groups(P>0.05).The total volume of gray matter in T2DM-MCI group was lower than that in T2DM group and control group,and the total volume of gray matter in T2DM group was lower than that in control group(P<0.05).Brain MRI showed that compared with the control group,the volume of gray matter in the superior temporal gyrus,middle temporal gyrus,fusiform gyrus,superior frontal gyrus,medial frontal lobe and anterior cuneus was significantly reduced in T2DM group,and the volume of gray matter in the hippocampus,parahippocampal gyrus,amygdala and limbic system of uncinate gyrus was decreased in addition to more extensive atrophy in the upper cerebral region in T2DM-MCI group.Compared with T2DM group,only the gray matter volume in the left middle temporal gyrus in T2DMMCI group was significantly reduced(P<0.05).Conclusion Gray matter atrophy can be seen in patients with diabetes-related cognitive

关 键 词：糖尿病 认知功能障碍 磁共振成像 脑灰质体积 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]