Shozushima Masaharu, Mori Futoshi, Yashiro Satoshi, Todate Yusuke, Oda Tomoyasu, Nagasawa Kan, Hasegawa Yutaka, Takebe Noriko, Sasaki Makoto, Ishigaki Yasushi
Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University, Yahaba 028-3695, Japan.
Division of Ultra-high Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba 028-3694, Japan.
Brain Sci. 2023 Jan 28;13(2):217. doi: 10.3390/brainsci13020217.
While type 2 diabetes (T2D) is a major risk for ischemic stroke, the associated vessel wall characteristics remain essentially unknown. This study aimed to clarify intracranial vascular changes on three-dimensional vessel wall imaging (3D-VWI) using fast spin echo by employing 7Tesla (7T) magnetic resonance imaging (MRI) in T2D patients without advanced atherosclerosis as compared to healthy controls.
In 48 T2D patients and 35 healthy controls, the prevalence of cerebral small vessel diseases and intracranial plaques were evaluated by 3D-VWI with 7T MRI.
The prevalence rate of lacunar infarction was significantly higher in T2D than in controls ( = 8 in T2D vs. = 0 in control, = 0.011). The mean number of intracranial plaques in both anterior and posterior circulation of each subject was significantly larger in T2D than in controls (2.23 in T2D vs. 0.94 in control, < 0.01). In T2D patients, gender was associated with the presence of intracranial plaques.
This is the first study to demonstrate the high prevalence of intracranial plaque in T2D patients with neither confirmed atherosclerotic disease nor symptoms by performing intracranial 3D-VWI employing 7TMRI. Investigation of intracranial VWI with 7T MRI is expected to provide novel insights allowing early intensive risk management for prevention of ischemic stroke in T2D patients.
虽然2型糖尿病（T2D）是缺血性中风的主要风险因素，但其相关的血管壁特征基本上仍不清楚。本研究旨在通过使用7特斯拉（7T）磁共振成像（MRI）的快速自旋回波技术，对无晚期动脉粥样硬化的T2D患者与健康对照者进行三维血管壁成像（3D-VWI），以阐明颅内血管变化。
在48例T2D患者和35例健康对照者中，通过7T MRI的3D-VWI评估脑小血管疾病和颅内斑块的患病率。
T2D患者的腔隙性梗死患病率显著高于对照组（T2D组为8例，对照组为0例，P = 0.011）。每个受试者前循环和后循环中颅内斑块的平均数量在T2D组显著多于对照组（T2D组为2.23个，对照组为0.94个，P < 0.01）。在T2D患者中，性别与颅内斑块的存在有关。
这是第一项通过使用7T MRI进行颅内3D-VWI，在既无确诊动脉粥样硬化疾病也无症状的T2D患者中证明颅内斑块高患病率的研究。预计通过7T MRI对颅内VWI进行研究将提供新的见解，以便对T2D患者进行早期强化风险管理以预防缺血性中风。
