摘要
目的:探讨扩散张量成像(DTI)对无外周缺血表现的2型糖尿病(T2DM)患者小腿肌肉早期改变的定量分析价值。方法:前瞻性收集2018年9月至2019年3月间南京医科大学附属无锡第二医院的无外周缺血表现的20例男性T2DM患者(年龄45~64岁)和20名匹配的男性健康志愿者(年龄46~62岁)作为健康对照,所有受试者均进行双下肢DTI。测量两侧腓肠肌内侧头(GM)、腓肠肌外侧头(GL)、胫骨前肌(TA)、比目鱼肌(SOL)的各向异性分数(FA)、表观扩散系数(ADC)及λ1、λ2、λ3值;分析FA、ADC与体质指数(BMI)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)及总胆固醇(TG)的相关性。采用两独立样本t检验及Pearson相关分析数据。结果:T2DM组TA、SOL的ADC高于对照组[TA:(1.77±0.15)与(1.66±0.11)×10^-3 mm^2/s,SOL:(1.83±0.10)与(1.75±0.16)×10^-3 mm^2/s],T2DM组TA的λ1、λ2、λ3[(2.30±0.21)、(1.63±0.17)、(1.38±0.13)×10^-3 mm^2/s]高于对照组[(2.17±0.12)、(1.51±0.13)、(1.31±0.12)×10^-3 mm^2/s],SOL的λ2、λ3[(1.74±0.11)、(1.53±0.12)×10^-3 mm^2/s]也高于对照组[(1.64±0.18)、(1.44±0.15)×10^-3 mm^2/s],差异均有统计学意义(t值:2.65~3.91,均P<0.05)。T2DM组FA、ADC与BMI、FBG、HbA1c、HDL、LDL及TG均无相关性(r值:-0.15~0.08,均P>0.05)。结论:DTI的定量参数特别是ADC能灵敏发现无外周缺血表现的T2DM患者小腿肌肉微结构改变;TA、SOL对T2DM相关微结构变化的扩散灵敏度高。
Objective To explore the quantitative analysis value of diffusion tensor imaging(DTI)for early changes of calf muscle in type 2 diabetes mellitus(T2DM)patients without peripheral ischemia.Methods From September 2018 to March 2019,20 male T2DM patients(age:45-64 years)without peripheral ischemia and 20 matched male healthy controls(age:46-62 years)who performed lower limb DTI in Wuxi Second Hospital Affiliated to Nanjing Medical University were prospectively analyzed.Fractional anisotropy(FA),apparent diffusion coefficient(ADC)andλ1,λ2,λ3 values of medial head of gastrocnemius(GM),lateral head of gastrocnemius(GL),tibialis anterior(TA)and soleus muscles(SOL)were measured respectively.The differences of DTI diffusion characteristics between 2 groups were compared by using independent-sample t test,and the correlation between FA,ADC and body mass index(BMI),fasting blood glucose(FBG),hemoglobin A 1c(HbA1c),high density lipoprotein(HDL),low density lipoprotein(LDL)and triglyceride(TG)were analyzed by Pearson correlation analysis.Results The ADC of TA and SOL in T2DM group((1.77±0.15)and(1.83±0.10)×10^-3 mm^2/s)was higher than that in control group((1.66±0.11)and(1.75±0.16)×10^-3 mm^2/s);λ1,λ2,andλ3 of TA in the T2DM group((2.30±0.21),(1.63±0.17)and(1.38±0.13)×10^-3 mm^2/s)were higher than those in control group((2.17±0.12),(1.51±0.13)and(1.31±0.12)×10^-3 mm^2/s);λ2 andλ3 of SOL were also higher than those in control group((1.74±0.11)vs(1.64±0.18)×10^-3 mm^2/s and(1.53±0.12)vs(1.44±0.15)×10^-3 mm^2/s;t values:2.65-3.91,all P<0.05).There were no significant correlations between FA,ADC and BMI,FBG,HbA1c,HDL,LDL and TG(r values:from-0.15 to 0.08,all P>0.05).Conclusions Quantitative parameters of DTI,especially ADC,can sensitively detect the microstructural changes of calf muscle in T2DM patients without peripheral ischemia.TA and SOL have high sensitivity to the diffusion of T2DM-related microstructural changes.
作者
付云雷
管士明
祁卉卉
顾静
李薇
张追阳
Fu Yunlei;Guan Shiming;Qi Huihui;Gu Jing;Li Wei;Zhang Zhuiyang(Department of Radiology,Wuxi Second Hospital Affiliated to Nanjing Medical University,Wuxi 214002,China;Department of Medicine,Huadong Sanatorium,Wuxi 214042,China)
出处
《中华核医学与分子影像杂志》
CAS
北大核心
2020年第12期716-720,共5页
Chinese Journal of Nuclear Medicine and Molecular Imaging
关键词
糖尿病
2型
弥散张量成像
肌
腿
Diabetes mellitus,type 2
Diffusion tensor imaging
Muscles
Leg
