Texture Analysis Based On Mri Of The Frontal Cortex Substructure In Type 2 Diabetic Mellitus

Objective: The purpose of this study was to analyze the relationship between the microstructural texture changes of frontal cortex and cognitive impairment in healthy volunteers and patients with type 2diabetes mellitus(T2DM).By identifying the microstructural changes of frontal cortex in patients with T2 DM,we search for the methods of early prevention,diagnosis and monitoring of diabetes-related cognitive dysfunction,and to provide a basis for the study of pathophysiological mechanism.Research design and methods: In this study,85 subjects with T2 DM and age-matched middle-aged and elderly subjects were recruited from outpatients and inpatients in the First Affiliated Hospital of University of South China from July 01,2017 to January 30,2020.All subjects received MMSE for cognitive assessment,followed by 3.0TMRI scans.The patients were divided into two groups according to whether they had T2 DW or not: T2 DM group and non-DM control group.There were 48 cases in T2 DM group and 37 cases in non-DM control group.First,the frontal lobe was segmented by Freesurfer software and the bilateralfrontal lobe volume and cortical thickness were calculated,and the independent sample T test was used to evaluate the difference between groups.The left and right frontal cortex were divided into 34 subregions by Brainnetome Atlas.Then texture features of each frontal lobe were quantified by intensity feature,gray co-occurrence matrix,gray difference matrix,gray area matrix,gray stroke length matrix and neighborhood gray difference matrix using pyradiomics toolkit,and Mann-Whitney U test was used to evaluate the differences between the two groups.Results : There was no significant difference in the volume and thickness of bilateral frontal cortex between T2 DM group and non-DM control groups.A total of 6324(93×68)textures features were extracted from 68(34×2)subregions of the left and right frontal cortex in T2 DM group and non-T2 DM group.Compared with the non-DM control group,the results showed that there were statistical differences in 72 textures in34 subregions of the right frontal cortex and 72 textures in 32 subregions of the left frontal cortex in the T2 DM group.Conclusions: Before the onset of cognitive impairment,the volume and thickness of frontal cortex did not change in patients with T2 DM,but the imaging texture features of frontal cortex subregions changed significantly.The microstructural changes of frontal lobe can be used as MRI biomarkers of T2 DM.The results of this study emphasize the importance of frontal cortex microstructure abnormalities in T2 DM andsupport the possibility of texture features as neuroimaging biomarkers in patients with T2 DM.