The Evaluation Of MRI In Cerebral Small Vessel Disease In Patients With Type2Diabetes Mellitus

Objective: The cerebral small vessel disease became the most important factors ofnervous system damage in aged with increasing morbidity of Diabetes II yearly. Ourstudy is to evaluate the manifestation of cerebral small vessel damaged by diabetes II,using noninvasive techniques of conventional MR imaging sequences andSusceptibility-weighted imaging (SWI), and to offer helpful information of clinicaldiagnosis, therapy, therapeutic and long term evaluation.Materials and Methods:Four hundred and thirty-seven neurology inpatients were recruited in our studybetween January2013and December2013,eighteen cases were excluded. Diabetesgroup and non-diabetes group were observed. All patients underwent brain MRI withaxial T1WI、axial T2WI、axial FLAIR、axial DWI、axial SWI and sagittal T2WIsequences in3.0T scanner. The incidence rate and distribution pattern of acuteinfarction, Cerebral micro hemorrhage，the number of lacunar infarction and thedegree of leukoaraiosis were recorded. We also recorded clinical data, medical historyand results of laboratory. All of the potential risk factors such as age, gender,hypertension, diabetes duration，Glycosylated hemoglobin, fasting blood glucose andhistory of cerebral apoplexy were included. Result:The incidence rate of infarctioncaused by small vessel occlusion was higher in diabetes group than in non-diabetesgroup (68.2%vs.43.2%). In large vessel occlusion group, the incidence rate ofinfarction in diabetes group was compared lower to non-diabetes group (31.8%vs.56.8%). There was significant statistical difference between the objects (X2=7.49，P<0.05). There was obviously statistical difference between diabetes group andnon-diabetes group（P<0.05）. Comparison to non-diabetes, diabetes group showed upmore serious degree in previous cerebral apoplexy, lacunar infarction andleukoaraiosis. There was no statistical difference in the occurrence rate of cerebralmicro-hemorrhage between the two groups (P>0.05). The severity of white matterloosened in periventricular area was in parallel with subcortical area. The level ofleukoaraiosis in diabetes group was related to age, Glycosylated hemoglobin,occurrence of lacunar infarction and the severity of cerebral micro-hemorrhage(P<0.05), and was not to history of diabetes，result of fasting blood glucose andgender. Conclusion: Small lesions was mainly presented in acute infarction happenedin diabetes II patients. The severity of lacunar infarction and leukoaraiosis occurred indiabetes group was severer than in non-diabetes group. In diabetes group, diabetesdurance, result of fasting blood glucose and gender had no correlation with the levelof leukoaraiosis. The risk factors of leukoaraiosis was related to Glycosylatedhemoglobin, age, the severity of lacunar infarction and history of cerebralmicro-hemorrhage.