| Objective：Compare the differences of hippocampus and the posterior cingulatedgyrus by proton magnetic resonance spectroscopy(1H-MRS)between patients withdiabetic encephalopathy(DE) and patients without diabetic encephalopathy,and discussthe changes and the correlated with cognitive function of metabolins on hippocampusand the posterior cingulated gyrus.Materials and Methods：Collect the patients during July2013-February2014inDalian University Affiliated Zhongshan Hospital.30patients with diabeticencephalopathy（DE)，and the patients without diabetic encephalopathy (30cases)were detected by proton magnetic resonance spectroscopy(1H-MRS). Volume ofintersest （ROI）which will be placed on hippocampus and the left posterior cingulatedgyrus (Right-handed patients often have the left hemisphere advantaged), Two groupsof patients were right-handed, had no exact history of mental,neurological and familyhistory which affected the cognitive function. Between the two groups of gender, ageand years of education were not statistically different. Observations are NAA,Cho,Crand MI,then count their ratios,such as NAA/Cr,Cho/Cr,MI/Cr and assessed withstatistical analysis. Meanwhile measured the Simple Intelligence Scale (MoCA) score.Between two groups significantly compared with Paired Samples T Test. in DEpatients we use the partial correlation analysis to analysis the correlation of metabolite ratios between the MoCA score.Differences were statistically significant while P＜0.05.Results：1.In DE group:（1）On the left and right hippocampus the mean values ofNAA/Cr ratios are1.10±0.72,1.35±1.45, and difference has no statistically significan（tP＞0.05）; Mean values on Cho/Cr ratios are2.60±3.68,1.80±2.81, and difference has nostatistically significant（P＞0.05）；Mean values on MI/Cr ratios are1.06±2.17,0.53±0.73, and difference has no statistically significant（P＞0.05）；（2）on the posterior cingulated gyrus the mean value of NAA/Cr ratio is1.50±0.51; themean value of Cho／Cr ratio is0.90±0.54; the mean value of MI/Cr ratio is0.32±0.35.2.The group who without diabetic encephalopathy:（1）on the left and righthippocampus the mean values of NAA/Cr ratios are3.89±7.41,5.06±16.23, anddifference has no statistically significant; Mean values on Cho/Cr ratios are1.40±1.18,1.49±1.60, and difference has no statistically significant；Mean values onMI/Cr are ratios0.10±0.06,0.25±0.79, and difference has no statistically significant；（2）on the posterior cingulated gyrus the mean value of NAA/Cr ratio is1.83±2.04; themean value of Cho/Cr ratio is0.86±0.35; the mean value of MI/Cr ratio is0.15±0.11.3.NAA/Cr ratio in left hippocampus decreased in DE patients,and difference hasstatistically significant（P＜0.05）; Cho/Cr ratio and MI/Cr ratio increased, anddifference has statistically significant（P＜0.05）.4.NAA/Cr ratio in right hippocampus decreased in DE patients,and difference hasstatistically significant（P＜0.05）; Cho/Cr ratio and MI/Cr ratio increased, anddifference has no statistically significant（P＞0.05）.5.MI/Cr in the posterior cingulated gyrus increased in DE patients, and differencehas statistically significant（P＜0.05）; NAA/Cr ratio slightly decreased,and differencehas no statistically significant（P＞0.05）; and Cho/Cr ratio slightly increased,anddifference has no statistically significant（P＞0.05）. 6.In DE patients the NAA/Cr ratio in left hippocampus is significant positivecorrelation with the scorer of MoCA, and difference has statistically significant（P＜0.01）.Conclusion：1.1H-MRS can be further confirmed from the metabolic level of the degree ofdiabetic encephalopathy it will diagnosis and evaluation of brain injury in diabeticpatients earlier.2.The cerebellar NAA/Cr,Cho/Cr and Ml/Cr ratios of hippocampus and theposterior cingulated gyrus can well reflect the severity of the DE patients.3.The decrease of NAA/Cr ratio in hippocampus may be one of the most importantbiomarkers in DE patients in cognitive dysfunction. |
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