磁共振扩散成像技术在2型糖尿病下肢神经病变诊断中的应用
发布时间：2018-08-26 18:10
【摘要】：目的:利用磁共振扩散加权神经成像(DW-MRN)及扩散张量成像(DTI)技术研究2型糖尿病周围神经病变患者胫神经及腓总神经的改变,探讨扩散成像技术在糖尿病下肢神经病变诊断中的应用价值。材料与方法:前瞻性纳入我院2型糖尿病伴周围神经病变患者(DPN)20名,2型糖尿病不伴周围神经病变患者(T2DM)20名及健康对照者(HC)20名。常规采集受试者一般情况资料,包括性别、年龄、身高、体重、糖尿病患者相关临床指标、肌电图运动神经传导速度(MCV)及密歇根神经病变筛查(MNSI)评分。所有受试者分别进行磁共振T1WI、T2WI/FS、MEDIC、DW-MRN、DTI序列扫描,利用磁共振后处理技术并参照解剖序列在DTI图像上选取感兴趣区,自动计算胫神经及腓总神经FA值及ADC值,测量三次取平均值;同时观察胫神经及腓总神经信号及形态的改变。采用SPSS 22.0处理数据,DPN组和T2DM组两组间计量资料比较采用两样本t检验,DPN组、T2DM组及HC组三组间计量资料比较采用单因素方差分析,并分析FA值及ADC值与神经传导速度以及临床指标的相关性。结果:(1)DPN组与T2DM组实验室相关生化指标及MNSI评分有差别,其中DPN组与T2DM组间Hb A1c、LDL-C、C肽及MNSI评分差异具有统计学意义(P0.05);(2)DPN组胫神经及腓总神经传导速度(43.42±3.59m/s,44.05±3.01m/s)较T2DM组(46.43±2.86m/s,46.83±2.86m/s)及HC组(46.89±2.75m/s,47.03±2.37m/s)慢,且差异具有统计学意义(P0.05);(3)DPN组、T2DM组及HC组胫神经FA值分别为0.528±0.073,0.582±0.048,0.593±0.069,腓总神经FA值分别为0.489±0.052,0.537±0.049,0.547±0.050,DPN组胫神经及腓总神经FA值均较T2DM组及HC组低,且差异具有统计学意义(P0.05);三组胫神经ADC值分别为1.173±0.103×10~(-3)mm~2/s,1.077±0.083×10~(-3)mm~2/s,1.070±0.077×10~(-3)mm~2/s,腓总神经ADC值分别为1.107±0.085×10~(-3)mm~2/s,1.027±0.075×10~(-3)mm~2/s,1.020±0.065×10~(-3)mm~2/s,DPN组胫神经及腓总神经ADC值均较T2DM组及HC组高,且差异具有统计学意义(P0.05)。(4)胫神经和腓总神经FA值与MCV呈正相关(r=0.696,P0.001;r=0.728,P0.001),而ADC值与MCV呈负相关(r=-0.672,P0.001;r=-0.636,P0.001)。(5)FA值与Hb A1c、LDL-C及病程呈负相关(r值分别为-0.397,-0.415,-0.341;P值均0.05),而与C肽呈正相关(r=0.355,P0.05);ADC值与Hb A1c、LDL-C、及病程呈正相关(r值分别为0.598,0.552,0.361;P值均0.05),而与C肽呈负相关(r=-0.512,P0.05)。结论:磁共振扩散加权神经成像及扩散张量成像技术可以显示胫神经及腓总神经的走行及定量评估糖尿病患者胫神经及腓总神经损伤情况。
[Abstract]:Objective: to study the changes of tibial nerve and common peroneal nerve in patients with type 2 diabetic peripheral neuropathy by diffusion weighted neurography (DW-MRN) and diffusive Zhang Liang imaging (DTI). To evaluate the value of diffusion imaging in the diagnosis of diabetic lower extremity neuropathy. Materials and methods: twenty patients with type 2 diabetes mellitus with peripheral neuropathy (DPN) and 20 patients with type 2 diabetes mellitus without peripheral neuropathy (T2DM) and 20 healthy controls with (HC) were included prospectively. The general data of subjects were collected routinely, including sex, age, height, weight, clinical indexes of diabetes mellitus, electromyogram motor nerve conduction velocity (MCV) and Michigan neuropathy screening (MNSI) score. All subjects were scanned with Mr T1WII / T2WI / FSSI / DW-MRNNI sequence respectively. The region of interest was selected from DTI images by magnetic resonance postprocessing technique and anatomic sequence. The FA and ADC values of tibial nerve and common peroneal nerve were calculated automatically, and the average values of ADC were measured three times. At the same time, the signal and morphological changes of tibial nerve and common peroneal nerve were observed. SPSS 22.0 was used to process data between DPN group and T2DM group. The measurement data of DPN group and HC group were compared by single factor analysis of variance (ANOVA). The correlation of FA and ADC with nerve conduction velocity and clinical indexes was analyzed. Results: (1) there were significant differences in laboratory biochemical indexes and MNSI scores between DPN group and T2DM group. There was significant difference in Hb A 1ct LDL-C peptide and MNSI score between DPN group and T2DM group (P0.05); (2). The conduction velocity of tibial nerve and peroneal nerve in DPN group (43.42 卤3.59 m 路s / s 44.05 卤3.01m/s) was slower than that in T2DM group (46.43 卤2.86 msP 路2.86m/s) and HC group (46.89 卤2.75ms-1 路s / r = 47.03 卤2.37m/s). The difference was statistically significant (P0.05); (3) the FA values of tibial nerve in DPN group and HC group were 0.528 卤0.073 卤0.048 卤0.593 卤0.069 and 0.489 卤0.052 卤0.049 卤0.537 卤0.049 卤0.547 卤0.050 respectively. The FA values of tibial nerve and common peroneal nerve in DPN group were lower than those in T2DM group and HC group. 涓斿樊寮傚叿鏈夌粺璁″鎰忎箟(P0.05);涓夌粍鑳缁廇DC鍊煎垎鍒负1.173卤0.103脳10~(-3)mm~2/s,1.077卤0.083脳10~(-3)mm~2/s,1.070卤0.077脳10~(-3)mm~2/s,鑵撴，
本文编号：2205739
[Abstract]:Objective: to study the changes of tibial nerve and common peroneal nerve in patients with type 2 diabetic peripheral neuropathy by diffusion weighted neurography (DW-MRN) and diffusive Zhang Liang imaging (DTI). To evaluate the value of diffusion imaging in the diagnosis of diabetic lower extremity neuropathy. Materials and methods: twenty patients with type 2 diabetes mellitus with peripheral neuropathy (DPN) and 20 patients with type 2 diabetes mellitus without peripheral neuropathy (T2DM) and 20 healthy controls with (HC) were included prospectively. The general data of subjects were collected routinely, including sex, age, height, weight, clinical indexes of diabetes mellitus, electromyogram motor nerve conduction velocity (MCV) and Michigan neuropathy screening (MNSI) score. All subjects were scanned with Mr T1WII / T2WI / FSSI / DW-MRNNI sequence respectively. The region of interest was selected from DTI images by magnetic resonance postprocessing technique and anatomic sequence. The FA and ADC values of tibial nerve and common peroneal nerve were calculated automatically, and the average values of ADC were measured three times. At the same time, the signal and morphological changes of tibial nerve and common peroneal nerve were observed. SPSS 22.0 was used to process data between DPN group and T2DM group. The measurement data of DPN group and HC group were compared by single factor analysis of variance (ANOVA). The correlation of FA and ADC with nerve conduction velocity and clinical indexes was analyzed. Results: (1) there were significant differences in laboratory biochemical indexes and MNSI scores between DPN group and T2DM group. There was significant difference in Hb A 1ct LDL-C peptide and MNSI score between DPN group and T2DM group (P0.05); (2). The conduction velocity of tibial nerve and peroneal nerve in DPN group (43.42 卤3.59 m 路s / s 44.05 卤3.01m/s) was slower than that in T2DM group (46.43 卤2.86 msP 路2.86m/s) and HC group (46.89 卤2.75ms-1 路s / r = 47.03 卤2.37m/s). The difference was statistically significant (P0.05); (3) the FA values of tibial nerve in DPN group and HC group were 0.528 卤0.073 卤0.048 卤0.593 卤0.069 and 0.489 卤0.052 卤0.049 卤0.537 卤0.049 卤0.547 卤0.050 respectively. The FA values of tibial nerve and common peroneal nerve in DPN group were lower than those in T2DM group and HC group. 涓斿樊寮傚叿鏈夌粺璁″鎰忎箟(P0.05);涓夌粍鑳缁廇DC鍊煎垎鍒负1.173卤0.103脳10~(-3)mm~2/s,1.077卤0.083脳10~(-3)mm~2/s,1.070卤0.077脳10~(-3)mm~2/s,鑵撴，
本文编号：2205739
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