MR diffusion imaging analysis of visual center injury in the brain of patients with type 2 diabetic retinopathy / 中华神经医学杂志

ABSTRACT

Objective To investigate the possible brain diffusion changes in different sites of the brain,particularly in areas associated with vision function,of patients with proliferative and nonproliferative retinopathy by using diffusion-weighted imaging (DWI).Methods Forty-five type 2 diabetic patients,admitted to our hospital from March 2012 to March 2013,were chosen in our study;according to the fundus examination,they were divided into group of proliferative retinopathy (n=15) group of non-proliferative retinopathy (n=15) and group of no retinopathy (n=15); another 15 healthy controls were chosen.T2WI and DWI with 3.0T magnetic resonance imaging (MRI) were performed; the apparent diffusion coefficient (ADC) values in the orbitofrontal cortex,cingulated gyrus,thalamus,dorsomedial and dorsolateral frontal cortex,and corona radiate were calculated; and then,Spearman's correlation analysis was performed between ADC values and both course of disease and glycosylated hemoglobin level.Results The ADC values of orbitofrontal cortex,cingulated gyrus and visual cortex in groups of proliferative and non-proliferative retinopathy were significantly increased as compared with group of no retinopathy and control group (F=95.268,P＜0.05); the ADC values of orbitofrontal cortex,cingulated gyrus and visual cortex in group of proliferative retinopathy were significantly increased as compared with those in group of non-proliferative retinopathy (P=0.004,0.001 and 0.009,respectively);no significant difference of them was noted between group of no retinopathy and control group (P＞0.05).The mean ADC values of orbitofiontal cortex,cingulated gyrus and visual cortex was positively correlated to the duration of disease (r=0.567 and P=0.001; r=0.491 and P=0.01; r=0.428 and P=0.003) and glycosylated hemoglobin level (r=0.336 and P=0.014; r=0.296 and P=0.049; r=0.370 and P=0.012).Conclusion Increased ADC values of visual center (orbitofrontal cortex,cingulated gyrus and visual cortex) conform the association between diabetic retinopathy and brain functioning impairment; DWI may serve to assess subclinical neurogical involvement in diabetic retinopathy,even when brain structural changes are absent.