中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2022, Vol. 17 ›› Issue (3): 618-624.doi: 10.4103/1673-5374.320996

• 原著:退行性病与再生 • 上一篇    下一篇

磁共振成像脑萎缩和病变指数可评估2型糖尿病患者的脑结构变化

  

  • 出版日期:2022-03-15 发布日期:2021-10-15

Assessment of structural brain changes in patients with type 2 diabetes mellitus using the MRI-based brain atrophy and lesion index

Heng Zhao1, 2, #, Fang Wang2, #, Guang-Hua Luo2, Hao Lei2, Fei Peng2, Qiu-Ping Ren2, Wei Chen2, Yan-Fang Wu2, Li-Chun Yin2, Jin-Cai Liu2, *, Shi-Nong Pan1, *   

  1. 1Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China; 2Department of Radiology, The First Affiliated Hospital of University of South China, Hengyang, Hunan Province, China
  • Online:2022-03-15 Published:2021-10-15
  • Contact: Jin-Cai Liu, MD, liujincai6353@163.com; Shi-Nong Pan, MD, cjr.panshinong@vip.163.com.
  • Supported by:
    This study was supported by the National Natural Science Foundation of China, No. 81271538 (to SNP); 345 Talent Project and the Natural Science Foundation of Liaoning Province of China, No. 2019-ZD-0794 (to SNP); the Natural Science Foundation of Hunan Province of China, Nos. 2017JJ2225 (to JCL), 2018JJ2357 (to GHL); Hunan Provincial Science and Technology Innovation Program of China, No. 2017SK50203 (to HZ).

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摘要：

2型糖尿病患者常出现认知功能障碍和脑结构异常，基于常规磁共振的脑萎缩和病变指数可评估常见的脑部变化及其与认知功能的相关性，因而其也可能用于反映2型糖尿病相关的全脑结构变化。（1）为证实这一假设，试验在2014年1月至2016年12月南华大学附属第一医院招募了136例（男64，女72）2型糖尿病患者以及健康体检者，年龄55-86岁，进行常规磁共振扫描及脑萎缩和病变指数评价；（2）结果显示，2型糖尿病合并认知障碍的脑萎缩和病变指数总分和亚类评分均高于健康体检对照组，但非2型糖尿病合并认知障碍组和2型糖尿病合并认知障碍组只有灰质病变和皮质下扩张血管周间隙评分存在差异。校正年龄后，脑萎缩和病变指数评分仍具有识别2型糖尿病合并认知障碍患者的能力；（3）提示基于磁共振T1加权成像和T2加权成像序列的脑萎缩和病变指数有诊断2型糖尿病合并认知障碍的临床价值，其中灰质病变-皮质下扩张血管周围间隙可能是2型糖尿病合并认知障碍的潜在影像学标志。试验于2013年11月9日经南华大学伦理委员会批准（批准号USC20131109003），并于2019年6月27日在中国临床试验注册中心进行回顾性注册（注册号ChiCTR1900024150）。

https://orcid.org/0000-0003-0498-3078 (Shi-Nong Pan)

关键词: 脑萎缩和病变指数, 磁共振成像, 2型糖尿病, 认知障碍, 脑结构变化, 灰质病变, 灰质病变-皮质下扩张血管周围间隙, 简易精神状态量表, T1加权图像, T2加权图像

Abstract: Patients with type 2 diabetes mellitus (T2DM) often have cognitive impairment and structural brain abnormalities. The magnetic resonance imaging (MRI)-based brain atrophy and lesion index can be used to evaluate common brain changes and their correlation with cognitive function, and can therefore also be used to reflect whole-brain structural changes related to T2DM. A total of 136 participants (64 men and 72 women, aged 55–86 years) were recruited for our study between January 2014 and December 2016. All participants underwent MRI and Mini-Mental State Examination assessment (including 42 healthy control, 38 T2DM without cognitive impairment, 26 with cognitive impairment but without T2DM, and 30 T2DM with cognitive impairment participants). The total and sub-category brain atrophy and lesion index scores in patients with T2DM with cognitive impairment were higher than those in healthy controls. Differences in the brain atrophy and lesion index of gray matter lesions and subcortical dilated perivascular spaces were found between non-T2DM patients with cognitive impairment and patients with T2DM and cognitive impairment. After adjusting for age, the brain atrophy and lesion index retained its capacity to identify patients with T2DM with cognitive impairment. These findings suggest that the brain atrophy and lesion index, based on T1-weighted and T2-weighted imaging, is of clinical value for identifying patients with T2DM and cognitive impairment. Gray matter lesions and subcortical dilated perivascular spaces may be potential diagnostic markers of T2DM that is complicated by cognitive impairment. This study was approved by the Medical Ethics Committee of University of South China (approval No. USC20131109003) on November 9, 2013, and was retrospectively registered with the Chinese Clinical Trial Registry (registration No. ChiCTR1900024150) on June 27, 2019.

Key words: brain atrophy and lesion index, cognitive impairments, gray matter lesions, magnetic resonance imaging, Mini-Mental State Examination, structural brain, subcortical dilated perivascular spaces, T1-weighted image, T2-weighted image, type 2 diabetes mellitus

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