The Value Of DTI In Assessing Patients With Mild Cognitive Impairment In Type 2 Diabetes

Objective: Diffusion tensor imaging(DTI)was used to evaluate the structural changes of brain nerve fibers in type 2 diabetic patients with mild cognitive impairment.To investigate the relationship between the structure of cranial nerve fibers and blood glucose and HbA1 c in patients with Type 2 diabetes mellitus and mild cognitive impairment.Research DTI technology can observe the integrity of the organization and determine the value of brain microstructure changes.Methods:28 patients with T2 DM MCI,25 patients with T2 DM and 26 health people in our hospital were enrolled.The results of variance analysis showed there was no statistically difference between age,gender,hypertension and metabolism disorders among the three groups,which is comparable.Subjects were assessed for cognitive function using the Mental State Easy Scale(MMSE)and Montreal Cognitive Assessment Scale(MOCA).Using daily living activity ability scale(ADL)to evaluate the daily living ability of the research object.Fasting blood glucose and HbA1 c were measured in the study subjects.FA and ADC values of the study subjects were collected using a magnetic resonance superconducting scanner and the correlation between FA,ADC values and blood glucose and glycosylated hemoglobin was analyzed.During the measurement,the spatial geometric deformation of the DTI image is first corrected,and the geometric distortion caused by the EPI sequence is partially eliminated.The FA value and the ADC value are obtained in the hippocampus,corpus callosum,and temporal lobe regions.In the corresponding parts of the cranium,two MRI researchers selected theROI(hippocampus,corpus callosum,and temporal lobe)with the same shape and superimposed on each other to measure the ADC and FA in the inner 8×8×2mm3range.Value,ROI placed in the head of hippocampus to reduce the partial volume effect of the cerebrospinal fluid around the hippocampus,left and right measured two times.The temporal lobe was measured in the coronal plane.From the level of the mammary gland to the posterior joint plane,the ROI was placed in the center of the white matter and measured twice.The ROIs were placed in the cross-section of the corpus callosum in the center of the knee and the center of compression.The average value was measured twice.Results:1.Three groups of subjects age,gender,hypertension and lipid metabolism was not statistically significant,comparable.MMSE score of T2 DM MCI patients was(19.32±3.56),lower than that of T2 DM patients(27.24±0.68)and healthy controls(29.62±0.49),and statistically significant was found;The Montreal cognitive assessment score of T2 DM MCI patients was(19.46±2.46),lower than that of T2 MD patients(26.62±1.13)and healthy controls(29.11 ± 0.98),and significantly statistical difference was found.(p <0.05);2.The fasting plasma glucose and HbA1 c in patients with T2 DM were higher than those in T2 DM and normal controls(p <0.05);3.The FA values of temporal lobe,hippocampus and corpus callosum in T2 DM MCI patients were lower than those in T2 DM patients and normal controls.The ADC of temporal lobe,hippocampus and corpus callosum in T2 DM patients with MCI were all higher than those in controls(P <0.05).There is a negative correlation in FA value and fasting blood glucose and glycosylated hemoglobin level.Conclusion:1.DTI can show the structure and direction of brain nerve fibers in patients with T2 DM MCI,suggesting that changes in nerve fiber structure may be the pathological mechanism of cognitive impairment in T2 DM MCI patients.DTI is of great value in assessing patients with T2 DM MCI.2.The degree of nerve fiber damage and blood glucose and glycosylated hemoglobin was positively correlated,long-term effective control of blood glucose levels,to delay the occurrence of cognitive dysfunction may play an important value.