16例新发2型糖尿病患者脑部皮层厚度异常变化的MRI初步研究

doi:10.24920/J1001-9294.2017.010

摘要/Abstract

摘要：

目的采用基于磁共振成像的全脑皮层厚度分析方法研究2型糖尿病患者脑部皮层厚度的异常变化。方法对16名新发2型糖尿病患者及16名健康志愿者行高分辨三维T1快速毁损梯度回波成像。基于Freesurfer软件（4.3.0版）计算全脑皮层厚度图,并采用基于脑回的感兴趣区法计算各个脑区的皮层厚度。以年龄和性别作为协变量进行协方差分析比较各个脑区的平均皮层厚度。采用基于表面的皮层厚度分析法在全脑水平比较皮层厚度的局部差异。结果 2型糖尿病患者双侧大脑皮层厚度（左侧：2.52±0.07 mm;右侧：2.51±0.08 mm）较对照组（左侧：2.56±0.09 mm;右侧：2.56±0.09 mm）变薄（P < 0.05）。2型糖尿病患者较正常对照组局部脑回变薄的脑区主要位于旁中央叶、中央后回、枕外侧回、舌回、楔前回、颞上回、颞中回、颞下回及后扣带回。左侧中扣带回及右侧颞下回皮层厚度与2型糖尿病病程呈负相关。结论新发2型糖尿病患者可发生脑部广泛皮层变薄。本研究结果证实了2型糖尿病可导致脑部微小结构发生改变。

关键词: 2型糖尿病, 脑, 大脑皮层, 皮层厚度, 磁共振成像

Abstract:

Objective The aim of this study is to investigate the cerebral cortical thickness changes in type 2 diabetes mellitus (T2DM) using a whole brain cortical thickness mapping system based on brain magnetic resonance imaging (MRI).Methods High resolution three-dimensional T1-weighted fast spoiled gradient recalled echo MR images were obtained from 16 patients with T2DM, as well as from 16 normal controls. The whole brain cortical thickness maps were generated, and the cortical thickness of each brain region was calculated according to gyral based regions of interest (ROI) using an automated labeling system by the Freesurfer software. We compared mean cortical thickness at each brain region by the analysis of covariance with age and sex as covariates. The regional difference of the cortical thickness over the whole brain was compared by the analysis of surface-based cortical thickness.Results Mean cortical thicknesses analysis showed bilateral cerebrum in the patients with T2DM (left: 2.52±0.07 mm; right: 2.51±0.08 mm) were significant thinner than those in the normal controls (left: 2.56±0.09 mm; right: 2.56±0.09 mm) (both P<0.05). Regional cortical thinning in T2DM was demonstrated in the paracentral lobule, postcentral gyrus, lateral occipital gyrus, lingual gyrus, precuneus, superior temporal gyrus, middle temporal gyrus, inferior temporal gyrus and posterior cingulate gyrus, compared to the normal controls. The cortical thickness of left middle cingulate and right inferior temporal gyrus were negatively correlated with the disease course.Conclusion A widespread cortical thinning was revealed in patients with T2DM by the analysis of brain cortical thickness on MR. Our finding supports the idea that T2DM could lead to subtle diabetic brain structural changes.

Key words: type 2 diabetes mellitus, brain, cerebral cortex, cortical thickness, magnetic resonance imaging

Chen Zhiye, Zang Xiujuan, Liu Mengqi, Liu Mengyu, Li Jinfeng, Gu Zhaoyan, Ma Lin. Abnormal Alterations of Cortical Thickness in 16 Patients with Type 2 Diabetes Mellitus: A Pilot MRI Study^△[J].Chinese Medical Sciences Journal, 2017, 32(2): 75-82.

图/表 4

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Brain lobe	Brain syrus	Cortical thickness（mm）		F value	P Value
Brain lobe	Brain syrus	T2DM n=16	NC n=16	F value	P Value
Front lobe	L Paracentral	2.50±0.12	2.65±0.13	13.16	0.001
Front lobe	R Paracentral	2.55±0.13	2.61±0.13	1.44	0.16
Parietal lobe	L postcentral	2.16±0.09	2.21±0.11	6.03	0.02
Parietal lobe	R postcentral	2.14±0.12	2.21±0.14	4.75	0.04
Occipital lobe	L occipital gyrus	2.28±0.11	2.83±0.13	4.72	0.04
	R occipital gyrus	2.32±0.11	2.47±0.12	13.57	0.00
	L lingual gyrus	1.98±0.08	2.12±0.18	8.74	0.01
	R lingual gyrus	1.95±0.12	2.06±0.19	5.66	0.02
	L precuneus cortex	2.43±0.09	2.50±0.11	6.76	0.02
	R precuneus cortex	2.41±0.12	2.50±0.10	4.70	0.04
Temporal lobe	L inf. temporal gyrus	2.89±0.12	2.99±0.13	6.30	0.02
	R inf. temporal gyrus	2.83±0.13	2.93±0.18	7.07	0.01
	L mid. temporal gyrus	2.87±0.11	2.97±0.15	5.78	0.02
	R mid. temporal gyrus	2.85±0.13	2.97±0.11	11.32	0.001
	L sup. temporal gyrus	2.63±0.11	2.71±0.15	1.75	0.09
	R sup. temporal gyrus	2.65±0.13	2.79±0.12	11.94	0.001
	L fusiform gyrus	2.77±0.11	2.81±0.14	0.90	0.37
	R fusiform gyrus	2.64±0.14	2.80±0.15	9.04	0.01
Limbic system	L post. Cingulate gyrus	2.70±0.11	2.82±0.13	8.12	0.01
	R post. Cingulate gyrus	2.64±0.14	2.84±0.10	12.33	0.001
	L isthmus of cingulate	2.56±0.16	2.61±0.20	0.79	0.43
	R isthmus of cingulate	2.43±0.16	2.60±0.20	4.52	0.04
	L insular cortex	2.99±0.18	3.06±0.19	1.10	0.28
	R insular cortex	2.93±0.14	3.09±0.17	8.60	0.01

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