| ObjectiveBy using DTI and1H-MRS between patients with NIDDM and healthy person group, compare the differences changes of FA、ADC and the metabolin on bilateral centrum ovale.Discuss the value of clinical application when combination with DTI and1H-MRS.Methods30patients with non-insulin-dependent diabetes mellitus and the healthy people(30cases) were detected by PHILIPS3.0T MRI on bilateral centrum ovale.First,both groups make Montreal Cognitive Assessment (MoCA).Then conventional MRI-. DTI,1H-MRS were applied on bilateral centrum ovale,1H-MRS peakareas were matched to the results of DTI for the corresponding volume.Then fractional anisotropy (FA) value、apparent diffusion coefficient (ADC) value、NAA/Cr、 Cho/Cr、Cho/NAA were compared among two groups. The scores of MoCA was analyzed between the groups. And then count their ratio and assessed with statistical analysis.Differences were statistically significant while P<0.05.Result1. The30samples of diabetes patients and30of healthy, the average age of the control group is55.87±4.37, the average age of the diabetes is55.97±5.96. There is no significant difference between the two groups. Diabetic group received on average12.30±3.48years of education, control group is12.07±2.94years. There is also no significant difference between the two groups (P>0.05)2. Mean values of FA on the left and right in diabetic group are0.44±0.03、0.46±0.04;mean values of ADC on the left and right are9.53±0.40、8.78±0.44.Mean values of FA on the left and right in control group are0.48±0.02、0.49±0.02;mean values of ADC on the left and right are8.724±0.24、8.59±0.25.Compared with control group,mean FA values decreased and mean ADC values increased (P<0.05). While left is obvious.3. Mean values of NAA/Cr on the left and right in diabetic group are2.18±0.20、2.21±0.21;mean values of Cho/Cr on the left and right are1.60±0.16、1.44±0.14; mean values of Cho/NAA on the left and right are0.74±0.11、0.66±0.10. Mean values of NAA/Cr on the left and right in control group are2.33±0.11、2.31±0.11;mean values of Cho/Cr on the left and right are1.41±0.09、1.40±0.11; mean values of Cho/NAA on the left and right are0.61±0.06,0.61±0.7. NAA/Cr in bilateral centrum semiovale decreased in NIDDM patients.By conventional criteria,this different is considered to be statistically significant(P<0.05).Cho/Cr in bilateral centrum semiovale increased in NIDDM patients.The different is considered to be statistically significant in both sides(P<0.05).Cho/NAA in bilateral centrum semiovale increased in NIDDM patients.The different is considered to be statistically significant(P<0.05).4. Montreal Cognitive of diabetic groups is23.80±2.34, normal control is27.47±1.25.The MoCA in diabetic group were lower than that in control group. Differences are extremely statistically significant (P<0.01).5. Linear correlation analysis between the data of diabetic group uses dual variable correlation analysis (Bivariate), and calculate the Spearman correlation coefficient.The correlation between DTI and MRA:①The left side centrum ovale of FA value with the NAA/Cr has a linear correlation (r=0.64,P<0.01),a correlation with Cho/Cr (r=-0.65,P<0.01), a correlation with Cho/NAA (r=-0.84,P<0.01).The ADC value with the NAA/Cr has a linear correlation(r=-0.37,P=0.04), a correlation with Cho/Cr(r=0.56,P<0.01), a correlation with Cho/NAA(r=0.62,P<0.01)②The right side centrum ovale of FA value with the NAA/Cr has no correlation (r=0.21,P=0.27), a correlation with Cho/Cr(r=-0.66,P<0.01), a correlation with Cho/NAA (r=-0.57,P<0.01). The ADC value with the NAA/Cr has a correlation (r=-0.38,P=0.04),no correlation with Cho/Cr and Cho/NAA(P>0.05) The correlation between MoCA and FA value、ADC value、NAA/Cr、Cho/Cr、 Cho/NAA:①The left side FA value with the MoCA (r=0.57, P<0.01) exist correlation;ADC value with the MoCA (r=-0.60, P<0.01) exist correlation; NAA/Cr with the MoCA (r=0.68, P<0.01) exist correlation; Cho/Cr with the MoCA (r=-0.37, P=0.04) exist correlation; Cho/NAA with the MoCA (r=-0.66, P<0.01) exist correlation.②The right side FA value、ADC value、NAA/Cr、Cho/Cr、Cho/NAA with the MoCA have no correlation(P>0.05).Conclusion1.Changes in cognitive function in patients with diabetes showed decline in FA、 NAA/Cr, and elevated in ADC、Cho/Cr、Cho/NAA.2. The left side centrum ovale of FA value with the NAA/Cr has a linear correlation, a correlation with Cho/Cr, a correlation with Cho/NAA.The ADC value with the NAA/Cr has a linear correlation, a correlation with Cho/Cr, a correlation with Cho/NAA.The right side centrum ovale of FA value with the NAA/Cr has no correlation, a correlation with Cho/Cr, a correlation with Cho/NAA. The ADC value with the NAA/Cr has a linear correlation,no correlation with Cho/Cr and Cho/NAA.3. Diabetes left side centrum ovale of FA value with the MoCA has a linear correlation; ADC value with the MoCA has a linear correlation; NAA/Cr with the MoCA has a linear correlation; Cho/Cr、Cho/NAA have correlation with the MoCA. Diabetes right side centrum ovale of FA value、ADC value、NAA/Cr、 Cho/Cr、Cho/NAA have no correlation with the MoCA.4. With the pathological changes development,the bilateral centrum ovale function has some changes. DTI could reflect the structural changes in local nerve fibers. And the fiber track by DTI will make better study about diabetic cerebral projection fibers anomaly,in order to discover the early changes of crerbral white matter induced by diabetes mellitus.5.1H-MRS is more sensitive than any other examination techniques on white matter. It could reflect varieties of centrum semiovale metabolites in NIDDM patients non-invasive and provide objective basis for diagnosis of cognitive dysfunction. 6. Combination with DTI and1HMRS could reflect the changes in the micro neural structure,and measure the content of metabolin,find the axonal injury and loss of myelin sheath at the same time.It can be used in the main clinical examination and neuropsychological testing,so that to find early cognitive dysfunction induced by diabetes mellitus. |
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