本文選題：型糖尿病　切入點(diǎn)：腦白質(zhì)　出處：《神經(jīng)解剖學(xué)雜志》2017年01期

【摘要】：目的:基于纖維束示蹤空間統(tǒng)計(jì)分析(TBSS)研究大腦擴(kuò)散張量成像(DTI)圖像,觀察血壓正常2型糖尿病(T2DM)患者腦白質(zhì)微結(jié)構(gòu)的改變,并探討雙側(cè)大腦半球間的腦白質(zhì)改變方法:本研究納入20名血壓正常的T2DM患者及20名年齡、性別匹配的正常對(duì)照。采用3.0T磁共振掃描儀采集大腦結(jié)構(gòu)像和DTI數(shù)據(jù),應(yīng)用基于體素的形態(tài)學(xué)分析(VBM)和TBSS方法比較兩組受試者間的大腦體積,白質(zhì)各向異性分?jǐn)?shù)(FA)和平均擴(kuò)散系數(shù)(MD)值的差異,以及兩組受試者左右側(cè)大腦半球DTI參數(shù)比值的差異。結(jié)果:與正常對(duì)照相比,血壓正常的T2DM患者大腦體積未見顯著減小(P0.05);大腦白質(zhì)完整性廣泛受損,尤以胼胝體膝部、左側(cè)內(nèi)囊前肢、輻射冠前上部、扣帶束及上額-枕束為著;右側(cè)上輻射冠、后輻射冠、扣帶束及上縱束FA值和MD值均有改變(P0.05);雙側(cè)大腦半球上輻射冠MD值升高,以左側(cè)升高更為顯著(P0.05)。結(jié)論:血壓正常的T2DM患者雙側(cè)大腦半球白質(zhì)微結(jié)構(gòu)廣泛損傷,尤以左側(cè)為著,TBSS分析有助于早期檢出上述改變。
[Abstract]:Objective: to study the brain diffusion imaging (DTI) images of patients with normal blood pressure type 2 diabetes mellitus (T2DM) by using TBSS-based tracer space analysis (TBSS), and to observe the changes of white matter microstructure in patients with normal blood pressure type 2 diabetes mellitus (T2DM).Methods: 20 T2DM patients with normal blood pressure and 20 age-matched normal controls were included in this study.Brain structure images and DTI data were collected by 3.0T magnetic resonance scanner. The difference of brain volume, white matter anisotropy fraction (FAA) and mean diffusion coefficient (MDR) between the two groups were compared by using morphologic analysis based on voxel and TBSS method.And the difference of the ratio of DTI parameters between the left and right cerebral hemispheres between the two groups.Results: compared with the normal controls, the cerebral volume of T2DM patients with normal blood pressure was not significantly decreased (P 0.05), and the white matter integrity was extensively impaired, especially in the genu of corpus callosum, the anterior limb of the left internal capsule, the upper anterior coronal radiation, the cingulate band and the superior frontal-occipital bundle.The values of FA and MD of the right upper radiative crown, posterior radiative crown, cingulate band and upper longitudinal beam were all changed (P 0.05), and the MD value of the bilateral cerebral hemisphere was higher than that of the left side (P 0.05).Conclusion: T2DM patients with normal blood pressure have extensive damage of white matter microstructure in bilateral cerebral hemispheres, especially in the left side, which is helpful for early detection of these changes.
【作者單位】： 第四軍醫(yī)大學(xué)唐都醫(yī)院放射科;
【基金】：國(guó)家自然科學(xué)基金(81471636)
【分類號(hào)】：R587.2;R445.2

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