Hu Rui, Gao Bingbing, Tian Shiyun, Liu Yangyingqiu, Jiang Yuhan, Li Wanyao, Li Yuan, Song Qingwei, Wang Weiwei, Miao Yanwei
Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
Front Neurosci. 2023 Jan 30;17:1061156. doi: 10.3389/fnins.2023.1061156. eCollection 2023.
To quantitatively evaluate the iron deposition and volume changes in deep gray nuclei according to threshold-method of quantitative susceptibility mapping (QSM) acquired by strategically acquired gradient echo (STAGE) sequence, and to analyze the correlation between the magnetic susceptibility values (MSV) and cognitive scores in type 2 diabetes mellitus (T2DM) patients.
Twenty-nine patients with T2DM and 24 healthy controls (HC) matched by age and gender were recruited in this prospective study. QSM images were used to evaluate whole-structural volumes (V), regional magnetic susceptibility values (MSV), and volumes (V) in high-iron regions in nine gray nuclei. All QSM data were compared between groups. Receiver operating characteristic (ROC) analysis was used to assess the discriminating ability between groups. The predictive model from single and combined QSM parameters was also established using logistic regression analysis. The correlation between MSV and cognitive scores was further analyzed. Multiple comparisons of all statistical values were corrected by false discovery rate (FDR). A statistically significant -value was set at 0.05.
Compared with HC group, the MSV of all gray matter nuclei in T2DM were increased by 5.1-14.8%, with significant differences found in bilateral head of caudate nucleus (HCN), right putamen (PUT), right globus pallidus (GP), and left dentate nucleus (DN) ( < 0.05). The V of most gray nucleus in T2DM group were decreased by 1.5-16.9% except bilateral subthalamic nucleus (STN). Significant differences were found in bilateral HCN, bilateral red nucleus (RN), and bilateral substantia nigra (SN) ( < 0.05). V was increased in bilateral GP, bilateral PUT ( < 0.05). V/V was also increased in bilateral GP, bilateral PUT, bilateral SN, left HCN and right STN ( < 0.05). Compared with the single QSM parameter, the combined parameter showed the largest area under curve (AUC) of 0.86, with a sensitivity of 87.5% and specificity of 75.9%. The MSV in the right GP was strongly associated with List A Long-delay free recall (List A LDFR) scores ( = -0.590, = 0.009).
In T2DM patients, excessive and heterogeneous iron deposition as well as volume loss occurs in deep gray nuclei. The MSV in high iron regions can better evaluate the distribution of iron, which is related to the decline of cognitive function.
根据通过策略性采集梯度回波（STAGE）序列获得的定量磁化率成像（QSM）阈值法，定量评估深部灰质核团中的铁沉积和体积变化，并分析2型糖尿病（T2DM）患者的磁化率值（MSV）与认知评分之间的相关性。
本前瞻性研究招募了29例T2DM患者和24例年龄及性别匹配的健康对照（HC）。使用QSM图像评估九个灰质核团的整体结构体积（V）、区域磁化率值（MSV）以及高铁区域的体积（V）。对所有QSM数据进行组间比较。采用受试者工作特征（ROC）分析评估组间的鉴别能力。还使用逻辑回归分析建立了单QSM参数和联合QSM参数的预测模型。进一步分析MSV与认知评分之间的相关性。所有统计值的多重比较采用错误发现率（FDR）校正。设定统计学显著性P值为0.05。
与HC组相比，T2DM组所有灰质核团的MSV升高了5.1%-14.8%，在双侧尾状核头部（HCN）、右侧壳核（PUT）、右侧苍白球（GP）和左侧齿状核（DN）中发现有显著差异（P<0.05）。T2DM组除双侧底丘脑核（STN）外，大多数灰质核团的V降低了1.5%-16.9%。在双侧HCN、双侧红核（RN）和双侧黑质（SN）中发现有显著差异（P<0.05）。双侧GP、双侧PUT的V增加（P<0.05）。双侧GP、双侧PUT、双侧SN、左侧HCN和右侧STN的V/V也增加（P<0.05）。与单QSM参数相比，联合参数显示最大曲线下面积（AUC）为0.86，灵敏度为87.5%，特异性为75.9%。右侧GP中的MSV与A表长延迟自由回忆（A表LDFR）评分密切相关（r=-0.590，P=0.009）。
在T2DM患者中，深部灰质核团出现过量且异质性的铁沉积以及体积丢失。高铁区域的MSV能更好地评估铁的分布，这与认知功能下降有关。
