| Background:In recent years,the morbidity of diabetes mellitus(DM)has elevated gradually.DM will cause serious injury to multiple systems and organs.Furthermore,many prediabetes patients who have suffered body damage due to hyperglycemia before they develop into DM.Therefore,early diagnosis and early intervention in the prediabetes population have great significance of delaying or even reversing the progression of DM in this populationObjective:Exploring the damage of hyperglycemia to brain function and mechanism provide the imaging basis for early clinical detection and timely interventionMaterials and Methods:From May 2019 to January 2020,54 subjects were included in this trial,including 18 prediabetes patients,18 healthy control subjects and 18 2-type DM patients.All the subjects had finished the overall cognitive function and psychology assessment.All the subjects were examined by using 3.0T MRI scanner to obtain images.Scan sequences includes axial 3D-BRAVO and intravoxel incoherent motion(IVIM).All the IVIM images of the experimental subjects were postprocessed on the postprocessor using Functool software.Not only measured the IVIM parameter values(f value,D*value and D value)of the interest areas of bilateral hippocampus and substantia nigra,but also the pseudo color maps can be rebuilt.According to the homogeneity of variance,the corresponding parameter values of IVIM were statistically analyzed by pairwise comparison of multiple independent samples after nonparametric test or multiple comparisons among sample means after one-way ANOVA.The intra-group differences in IVIM parameter values of the left and right hippocampus were statistically analyzed by paired sample t testResult:1.Neuropsychological assessment results showed that the Montreal Cognitive Assessment(MoCA)scores of the normal control group,the pre-diabetes group and the diabetes group were respectively 25.17±1.86,23.06±2.46 and 22.67±3.40,the differences in MoCA scores between the three groups were statistically significant(P<0.05).The MoCA scores of prediabetic group and diabetic group were slightly lower than the normal control group’s score,which had statistically significant difference(P<0.05).The MoCA scores between prediabetic group and diabetic group had no statistically significant difference(P>0.05).The Mini-mental State Examination(MMSE),Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)scores among the three groups had no statistically significant difference(P>0.05).2.The right hippocampal f values of the normal control group,the prediabetic group and the diabetic group were respectively 37.71±15.69,17.12±7.80 and 16.28±9.21.The left hippocampal f values of the three groups were respectively 38.18±18.42,16.84±10.7 and 15.76±5.12.The right hippocampal D values of the three groups were respectively 7.66±0.37,7.38±0.21 and 7.21±0.42.The left hippocampal D values of the three groups were respectively 7.62±0.50,7.29±0.37 and 7.26±0.41.Compared to the normal control group,the perfusion fraction f values and diffusion coefficient D values of bilateral hippocampus were reduced in both prediabetic group and diabetic group with statistically significant difference(P<0.05).And the pseudo diffusion coefficient D*values of the three groups had no statistically significant difference(P>0.05).3.The f,D and D*values of bilateral substantia nigra of the three groups had no statistically significant difference(P>0.05).Conclusion:IVIM-MRI can reflect the declining blood perfusion and microstructural water molecule diffusion of hippocampal of diabetic and prediabetes patients due to the increase of blood glucose,which proves that hyperglycemia would cause hemodynamics changes and microstructural damage of hippocampal.This result can provide imaging evidence for clinical intervention and treatment. |
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