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动脉自旋标记灌注磁共振成像显示糖尿病性视网膜病变患者特定的脑血流改变。

Altered resting cerebral blood flow specific to patients with diabetic retinopathy revealed by arterial spin labeling perfusion magnetic resonance imaging.

机构信息

Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China.

Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, PR China.

出版信息

Acta Radiol. 2021 Apr;62(4):524-532. doi: 10.1177/0284185120932391. Epub 2020 Jun 17.

Abstract

BACKGROUND

Previous neuroimaging studies have shown that patients with diabetic retinopathy (DR) were accompanied by abnormalities in cerebral functional and structural architecture, whereas the resting cerebral blood flow (CBF) alterations in patients with DR are not well understood.

PURPOSE

To explore CBF alterations in patients with DR using pseudo-continuous arterial spin labeling (pCASL) imaging.

MATERIAL AND METHODS

Thirty-one individuals with DR (15 men, 16 women; mean age = 53.38 ± 9.12 years) and 33 healthy controls (HC) (12 men, 21 women; mean age = 51.61 ± 9.84 years) closely matched for age, sex, and education, underwent pCASL imaging scans. Two-sample T test was conducted to compare different CBF values between two groups.

RESULTS

Patients with DR exhibited significantly increased CBF values in the left middle temporal gyrus (Brodmann's area, BA 22) and the bilateral supplementary motor area (BA3) and decreased CBF values in the bilateral calcarine (BA17,18) and bilateral caudate relative to HC group (two-tailed, voxel level at  < 0.01, Gaussian random field (GRF), cluster level at  < 0.05). Moreover, the HbA1c (%) level showed a positive correlation with CBF values in the bilateral caudate (r = 0.473,  = 0.007) in patients with DR.

CONCLUSION

Our results highlighted that patients with DR had abnormal CBF values in the visual cortices, caudate, middle temporal gyrus, and supplementary motor area, which might reflect vision and sensorimotor and cognition dysfunction in patients with DR. These findings might help us to understanding the neural mechanism of patients with DR.

摘要

背景

先前的神经影像学研究表明,糖尿病视网膜病变(DR)患者的大脑功能和结构存在异常,而 DR 患者的静息脑血流(CBF)改变尚不清楚。

目的

使用伪连续动脉自旋标记(pCASL)成像技术探讨 DR 患者的 CBF 改变。

材料与方法

共纳入 31 名 DR 患者(男 15 例,女 16 例;平均年龄 53.38 ± 9.12 岁)和 33 名健康对照者(男 12 例,女 21 例;平均年龄 51.61 ± 9.84 岁),年龄、性别和教育程度相匹配,所有受试者均行 pCASL 成像扫描。采用两样本 t 检验比较两组间不同 CBF 值的差异。

结果

与 HC 组相比,DR 患者左侧颞中回(Brodmann 区 22 区)、双侧辅助运动区(BA3)的 CBF 值显著升高,双侧楔前回(BA17、18)和双侧尾状核的 CBF 值显著降低(双侧,体素水平  < 0.01,高斯随机场(GRF)校正,簇水平  < 0.05)。此外,DR 患者的 HbA1c(%)水平与双侧尾状核的 CBF 值呈正相关(r=0.473,P=0.007)。

结论

本研究结果提示 DR 患者的视觉皮质、尾状核、颞中回和辅助运动区存在 CBF 值异常,可能反映了 DR 患者的视觉、感觉运动和认知功能障碍。这些发现可能有助于我们理解 DR 患者的神经机制。

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