Study On Intravoxel Incoherent Motion Imaging Of Medial Temporal Lobe In Patients With Type 2 Diabetes Mellitus

Objective: Type 2 diabetes(T2DM)can cause multiple organ and organ complications.Among them,the central nervous system is one of the most vulnerable parts,and its main clinical manifestation is the decline of cognitive function.There is also evidence that women are more affected by these complications.However,the pathophysiological mechanism of chronic brain injury caused by type 2 diabetes mellitus remains to be elucidated.IVIM imaging can noninvasively detect cerebral micro-vascular perfusion and brain parenchymal microstructural changes.Therefore,the purpose of this study is to evaluate the changes of IVIM parameters in medial temporal lobe of patients with T2 DM by intravoxel incoherent motion imaging(IVIM),and to explore whether there are gender differences in the effects of T2 DM on medial temporal lobe.Research design and methods: This study used a case-control design.From July01,2018 to January 30,2019,middle-aged and elderly adults in outpatient and inpatient departments of the First Affiliated Hospital of South China University and matched non-DM subjects were recruited.All subjects underwent a cognitive assessment of the Mini-Mental State Examination Scale(MMSE)and subsequently performed a 3.0T magnetic resonance scan.A total of 56 subjects were collected,excluding 2 cases and remaining 54 cases,including 27 cases of T2 DM and 27 cases of non-DM.Firstly,the subjects were divided into T2 DM group and non-DM group according to whether they had type 2 diabetes or not.Then control the gender difference,divide the male into the T2 DM group and the non-DM group,13 males in the T2 DM group and 16 males in the non-DM group.The women were divided into two groups: the T2 DM group and the non-DM group.There were 14 women in the T2 DM group and 11 women in the non-DM group.The medial temporal cortex volume and IVIM parameters of subjects in general,male and female groups were analyzed and compared: D value,f value,D* value and fD * value.Results : Compared with the non-DM female control group,the IVIM parameters in the medial temporal lobe of the female subjects with T2 DM have wide and significantdifferences,which are manifested in the following aspects:(1)the D values ? ? of IVIM parameters in female subjects of T2 DM were statistically different(p<0.05)in hippocampus,amygdala,entorhinal cortex and sacral cortex,with significant in entorhinal cortex(p<0.01);(2)The D* values of IVIM parameters in female subjects of T2 DM were statistically different(p<0.05)in hippocampus,entorhinal cortex and parahippocampal gyrus cortex,and significant in hippocampus and entorhinal cortex(p<0.01);(3)The f values ? ? of IVIM parameters in female subjects of T2 DM were statistically different(p<0.05)in hippocampus,amygdala,entorhinal cortex and temporal cortex,and significant in temporal cortex(p<0.01);(4)The fD * values? ? of IVIM parameters in female subjects of T2 DM were statistically different(p<0.05)in hippocampus,amygdala,entorhinal cortex,parahippocampal gyrus cortex and temporal cortex,and significant in hippocampus(p<0.01).Compared with the non-DM male control group,the D value and fD * value of IVIM parameters in T2 DM male subjects were statistically different(p<0.05)in the parahippocampal gyrus cortex.Compared with the general control group of T2 DM,there were significant differences in the D values and f values of IVIM parameters in the temporal cortex of the subjects with T2DM(p < 0.01).Conclusions: In this study,IVIM imaging technique was used to study the changes of medial temporal lobe perfusion and diffusion parameters in patients with T2 DM and between different genders.The following conclusions were drawn:(1)This study showed that the IVIM perfusion parameters of the medial temporal lobe of the female subjects with T2 DM had wide and significant differences,especially in the hippocampus,which indicated that the compensatory effects of T2 DM on the female cerebral vessels were earlier and wider.(2)Compared with the control group,there was no significant difference in MMSE score and volume between the subjects in the T2 DM group,which indicated that IVIM imaging could reflect the changes of medial temporal lobe cerebral blood flow or brain parenchymal microstructures in the patients with T2 DM earlier than cognitive impairment and brain atrophy.(3)The D value of IVIM can reflect the diffusion degree of interstitial fluid,so combining with the values of f,D*,and fD *,it has the potential to infer the equilibrium state.