Automated measurement of brain and white matter lesion volume in type 2 diabetes mellitus.
Automated measurement of brain and white matter lesion volume in type 2 diabetes mellitus.
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DOI：
10.1007/s00125-007-0688-y
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发表时间：
2007-07
期刊：
影响因子：
8.2
通讯作者：
Pluim, J. P. W.
中科院分区：
文献类型：
--
作者：
Jongen, C.;van der Grond, J.;Kappelle, L. J.;Biessels, G. J.;Viergever, M. A.;Pluim, J. P. W.
关键词：
2型糖尿病与脑萎缩和认知能力下降有关，但与缺血性白色病变的关系尚不清楚。以前的神经影像学研究主要使用半定量评定量表来测量萎缩和白色病变（WML）。在这项研究中，我们使用了自动分割技术来调查2型糖尿病，几个糖尿病相关的危险因素和认知与脑组织和WML体积的关系。使用在10个手动分割数据集上训练的k-最近邻分类器对来自基于人群的样本的99名2型糖尿病患者和46名对照参与者的磁共振图像进行分割。评估了白色物质、灰质、侧脑室、脑脊液（不包括侧脑室）和WML体积。分析调整了年龄、性别、教育水平和颅内体积。2型糖尿病与灰质体积较小（−21.8 ml; 95% CI −34.2，−9.4）、侧脑室体积较大（7.1 ml; 95% CI 2.3，12.0）和白色病变体积较大（56.5%; 95% CI 4.0，135.8）相关，而白色体积未受影响。在对男性和女性的单独分析中，糖尿病的影响仅在女性中显着。萎缩与较大WML体积的组合表明2型糖尿病与脑中的混合病理学相关。观察到的性别差异是意外的，需要在进一步的研究中解决。本文的在线版本（doi：10.1007/s 00125 -007-0688-y）包含乌得勒支糖尿病脑病研究组的成员名单，授权用户可使用。
Type 2 diabetes mellitus has been associated with brain atrophy and cognitive decline, but the association with ischaemic white matter lesions is unclear. Previous neuroimaging studies have mainly used semiquantitative rating scales to measure atrophy and white matter lesions (WMLs). In this study we used an automated segmentation technique to investigate the association of type 2 diabetes, several diabetes-related risk factors and cognition with cerebral tissue and WML volumes. Magnetic resonance images of 99 patients with type 2 diabetes and 46 control participants from a population-based sample were segmented using a k-nearest neighbour classifier trained on ten manually segmented data sets. White matter, grey matter, lateral ventricles, cerebrospinal fluid not including lateral ventricles, and WML volumes were assessed. Analyses were adjusted for age, sex, level of education and intracranial volume. Type 2 diabetes was associated with a smaller volume of grey matter (−21.8 ml; 95% CI −34.2, −9.4) and with larger lateral ventricle volume (7.1 ml; 95% CI 2.3, 12.0) and with larger white matter lesion volume (56.5%; 95% CI 4.0, 135.8), whereas white matter volume was not affected. In separate analyses for men and women, the effects of diabetes were only significant in women. The combination of atrophy with larger WML volume indicates that type 2 diabetes is associated with mixed pathology in the brain. The observed sex differences were unexpected and need to be addressed in further studies. The online version of this article (doi:10.1007/s00125-007-0688-y) contains a list of members of the Utrecht Diabetic Encephalopathy Study Group, and is available to authorised users.
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