Evaluation Of Myocardium Microcirculation In Diabetes Patients Using Intravoxel Incoherent Motion Imaging: A Pilot Study

Part 1Myocardium Microcirculation Study in a Healthy Chinese Population using Intravoxel Incoherent Motion ImagingPurpose This study explored myocardium microcirculation in a healthy Chinese population using cardiac magnetic resonance?CMR?intravoxel incoherent motion imaging?IVIM?.Material and Methods Eighty healthy volunteers were enrolled in this study?ages 8-76y?.All subjects performed 3.0T cardiac magnetic resonance examination from March 2015 to August2019,including 44 males?21-76y?and 36 females?8-75y?.All subjects received cardiac cine imaging,and short-axis CMR-IVIM of the apex,middle and basal layers of the left ventricle?LV?using multiple b values?0,20,50,80,100,120,200,300,500 s/mm2?.Using Functool 9.4.05 a post-processing software,IVIM parameters [apparent diffusion coefficient?ADC?fast?ADC_slow?f?fraction of ADCfast?] were measured based on the best image quality layer.Reportcard Software was used to measure LV structural and functional parameters.The intraclass correlation coefficient?ICC?and the Bland-Altman test were used to assess the consistency of IVIM parameters.Spearman correlation analysis was completed between IVIM parameters,age,and Body Mass Index?BMI?.The differences of IVIM parameters were analyzed among people of different sex and age.Results?1?Left ventricular structural [LVEDV?left ventricular end-diastolic volume?, LVESV?left ventricular end-systolic volume?,LVmass?left ventricular mass?] and function [CO?cardiac output?] parameters and Body mass index?BMI?in males were higher than in females?P<0.05?.?2?The IVIM parameters were shown to have better intra-observer and inter-observer consistency?all ICC?0.75?.Bland-Altman analysis also showed better intra-observer and inter-observer consistency.?3?ADCfast decreased as female age increased?rs=-0.37,p=0.01?.However,IVIM parameters had no correlation with BMI regardless of gender.?4?ADCfast in the female group showed a statistically significant difference across ages.?5?The ADC_slow and f in the male group was lower than in the female group?p<0.05?,however,ADCfast showed no statistically significant difference among genders.Conclusion IVIM parameters in healthy Chinese volunteers provided better consistency.There was a negative correlation between ADCfast and age in among female participants.Part 2Evaluation of Myocardium Microcirculation in Healthy Population and Diabetes Patients using Intravoxel Incoherent Motion Imaging: a Control StudyPurpose To preliminarily study myocardium microcirculation in diabetes patients using intravoxel incoherent motion imaging?IVIM?.Material and Methods24 normal volunteers?15 male,mean age,48.63±10.91y?and 17 diabetic volunteers?8 male,mean age,55.71±12.72y?were enrolled in this study from March 2015 to August 2019.All of them performed CMR-IVIM on 3.0T magnetic resonance on the apex,middle and basal layers of the left ventricle?LV?using multiple b values?0,20,50,80,100,120,200,300,500 s/mm2?.Using Functool 9.4.05 a post-processing software,IVIM parameters [apparent diffusion coefficient?ADC?fast ? ADC_slow ? f?fraction of ADCfast?] were measured based on the best image quality layer.Reportcard Software was used to measure LV structural and functional parameters.The intraclass correlation coefficient?ICC?and were used to assess the consistency of IVIM parameters.We analyzed the difference of myocardial microcirculation between normal subjects and diabetes.Results There was no significant difference in left ventricular structural [LVEDV?left ventricular end-diastolic volume?,LVESV?left ventricular end-systolic volume?,LVmass?left ventricular mass?] parameters and function [LVEF?left ventricular ejection fraction?,CO?cardiac output?,CI?cardiac index?] parameters between normal and diabetic subjects?p>0.05?.ADCfast values in diabetic volunteers?112?56.4¹89?mm2/s?were lower than normal volunteers?131?101²53?mm2/s??P=0.006?.Conclusion It's helpful to evaluate myocardial microcirculation in diabetic patients using IVIM imaging.