MR Cerebral Perfusion Imaging In The Clinical Application Of Diabetic Retinopathy Patients With Changes In Cerebral Microcirculation

Objective:Before has not yet occurred in patients with brain morphological changes,assessment of cerebral perfusion in patients with diabetic retinopathy,a prospective study in patients with diabetic retinopathy early change in cerebral microcirculation,provide diagnostic basis for early clinical treatment of cerebral microvascular disease,at the same time comparing different approaches of cerebral microcirculation perfusion abnormal detection rate.Methods:A total of 56 outpatients,physical examination patients and inpatients in the fourth affiliated hospital of kunming medical university from June 2017 to March 2019 were selected,among which 10 patients with diabetic retinopathy and 24 patients with non-retinopathy were selected as group A and group B respectively,and 21 healthy volunteers were selected as control group C.Normal mri head scan,MRA,dce-pwi and ASL scan were performed on subjects in resting state.Blood pressure,fasting blood glucose,hemoglobin ale,and renal function were measured before magnetic resonance imaging.SPM software based on matlab was used for format conversion and preprocessing of the obtained images,and regions with significant differences in CBF between diabetic patients and the normal control group were measured.Image post-processing was conducted on ASL and PWI in adw4.7 post-processing workstation,and the interest area was selected manually.The average CBF value of ASL and the perfusion parameters of rCBF,rCBV,MTT and TTP of PWI were measured to analyze the cerebral perfusion obtained by the two methods.SPSS 17.0 software package was used for statistical analysis,and chi-square test was performed for the gender of the subjects in the three groups.Variance analysis was performed for age,blood pressure,fasting blood glucose value and glycosylated hemoglobin value,respectively.Independent sample t test was performed for the course of diabetes in group A and group B.The perfusion parameters of ASL and PWI in the three groups were statistically analyzed to determine whether there were significant differences between the groups.Finally,the results of ASL and PWI were compared to determine whether there were differences between the two perfusion methods.Of three groups of ASL and PWI perfusion parameters using normal distribution and f test,to conform to normal distribution or f rank and inspection of the data,or analysis of variance(ANOVA),with P<0.05 for the difference is statistically significant,finally,the data was statistically significant to least significant difference(LSD)and two rank and inspection,between the two groups compare the ASL and PWI two different detected microcirculation perfusion method the number of abnormal brain area,evaluate the sensitivity of the two methods of cerebral microcirculation perfusion.Results:(l)ASL The average CBF values of the left cerebellar hemisphere,left cerebellar tonsil,bilateral inferior temporal gyrus,left straight gyrus,left cingulate gyrus and bilateral median frontal gyrus in group A were lower than those in group B and group C(P<0,05),and the average CBF values of the pons and left anterior central gyrus in group A were higher than those in group B and group C(P<0.05).(2)PWIrCBV in group A of left occipital lobe,right inferior temporal gyrus and left cingulate gyrus was lower than that in group B and C(P<0.05),and rCBV in group A of right parahippocampal gyrus was higher than that in group B and C(P<0.05);left cerebellar tonsil,left inferior temporal gyrus,double The rCBF of group A was lower than group B and group C(P<0.05);The TTP of left cerebellar hemisphere,left cerebellar tonsil,left inferior temporal gyrus,bilateral medial frontal gyrus and right cingulate gyrus in group A was higher than that in group B and group C(P<0.05),while the TTP of right pons and right parahippocampal gyrus in group A was lower group B and C(P<0.05),and MTT of right pons and left parahippocampal gyrus in group A was lower than that in group B and C(P<0.05).(3)The consistency coefficient of the two cerebral perfusion methods was 0.706,indicating that the detection of abnormal perfusion in different brain areas by ASL was consistent with PWI.Conclusions:(1)abnormal perfusion of mri brain in the brain motor center,visual projection area,limbic system and other areas in patients with diabetic retinopathy suggests that changes in brain microcirculation may occur at the same time as retinopathy in diabetic patients.(2)ASL and DSC-PWI have similar ability to detect changes in cerebral microcirculation in patients with diabetic retinopathy.