Zhou Hong, Yang Juan, Xie Peihan, Dong Yulan, You Yong, Liu Jincai
Department of Radiology of the First Affiliated Hospital, University of South China, Hengyang 421001, China.
Department of Radiology of the First Affiliated Hospital, University of South China, Hengyang 421001, China.
Clin Chim Acta. 2017 Jul;470:14-19. doi: 10.1016/j.cca.2017.04.019. Epub 2017 Apr 24.
Cerebral microbleeds (CMBs), a typical imaging manifestation marker of sporadic cerebral small vessel disease, play a critical role in vascular cognitive impairment, which is often accompanied by diabetes mellitus (DM). Hence, CMBs may, in part, be responsible for the occurrence and development of cognitive impairment in patients with diabetes. Novel magnetic resonance imaging (MRI) sequences, such as susceptibility-weighted imaging and T2*-weighted gradient-echo, have the capability of noninvasively revealing CMBs in the brain. Moreover, a correlation between CMBs and cognitive impairment in patients with diabetes has been suggested in applications of functional MRI (fMRI). Since pathological changes in the brain occur prior to observable decline in cognitive function, neuroimaging may help predict the progression of cognitive impairment in diabetic patients. In this article, we review the detection of CMBs using MRI in diabetic patients exhibiting cognitive impairment. Future studies should emphasize the development and establishment of a novel MRI protocol, including fMRI, for diabetic patients with cognitive impairment to detect CMBs. A reliable MRI protocol would also be helpful in understanding the pathological mechanisms of cognitive impairment in this important patient population.
脑微出血（CMBs）是散发性脑小血管病的典型影像学表现标志物，在血管性认知障碍中起关键作用，而血管性认知障碍常伴有糖尿病（DM）。因此，CMBs可能在一定程度上导致糖尿病患者认知障碍的发生和发展。新型磁共振成像（MRI）序列，如磁敏感加权成像和T2*加权梯度回波成像，能够无创地显示脑内的CMBs。此外，功能磁共振成像（fMRI）的应用提示了CMBs与糖尿病患者认知障碍之间的相关性。由于大脑的病理变化发生在认知功能出现明显下降之前，神经影像学检查可能有助于预测糖尿病患者认知障碍的进展。在本文中，我们综述了利用MRI对存在认知障碍的糖尿病患者进行CMBs检测的情况。未来的研究应着重为存在认知障碍的糖尿病患者开发和建立一种新型MRI方案，包括fMRI，以检测CMBs。一个可靠的MRI方案也将有助于理解这一重要患者群体认知障碍的病理机制。
