贵州医科大学学报

2013, v.38;No.162(03) 257-260

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垂体后叶T1WI信号强度与2型糖尿病患者下丘脑-垂体轴功能的相关性
Correlation between the Signal Intensity of T1-weighted MR Images of Pituitary Posterior Lobe and the Function of Hypothalamicpituitary Axis in Type 2 Diabetes Patients

华俊;张余;王学建;
HUA Jun1,ZHANG Yu2,WANG Xuejian3(1.Radiology Department of Chongqing Cancer Institute,Chongqing 400030,China;2.Radiology Department of Southwest Hospital of the Third Military Medical University,Chongqing 400038,China;3.Radiology Department of Guihang Guiyang Hospital,Guiyang 550009,Guizhou,China)

摘要(Abstract):

目的:探讨垂体后叶MR T1WI信号强度特征在评估2型糖尿病患者下丘脑-垂体功能轴中的价值。方法:选择经临床确诊的2型糖尿病患者53人和30例正常人,按照血糖控制情况将糖尿病患者分为控制理想组(12人),控制尚可组(18人)和控制较差组(23人);所有研究对象均行垂体矢状位MRT1WI检查,测量各组垂体后叶信号强度与脑桥信号强度比值,对控制较差组中5名患者经系统治疗后(2~3月)随访,观察治疗前、后垂体后叶信号强度变化;对控制较差组中23名患者测定血清抗利尿激素(ADH)浓度,将其与信号强度作相关性分析。结果:正常组与血糖控制理想组及控制尚可组的垂体后叶信号比值差异无统计学意义(P=0.078,P=0.061),血糖控制较差组的垂体后叶信号强度比值低于正常人(P=0.000),血糖控制理想组与控制尚可组的信号强度比值差异无统计学意义(P>0.05),血糖控制理想组与控制尚可组信号强度均高于控制较差组(P<0.05);5名控制较差组的患者治疗前、后垂体后叶信号强度比值平均为1.12±0.14,1.23±0.11,治疗后信号强度较治疗前升高(P<0.05)。结论:2型糖尿病患者血糖控制理想者及控制尚可者垂体后叶ADH含量无明显减少,血糖控制较差的2型糖尿病患者垂体后叶ADH含量减少;垂体后叶T1WI的信号强度在一定程度上反映2型糖尿病患者下丘脑-垂体功能状态。
Objective: To investigate the application significance of the signal intensity of T1-weighted MR images on pituitary posterior lobe in the evaluation of hypothalamic-pituitary axis function in type 2 diabetes patients.Methods: Fifty-three confirmed type 2 diabetes(T2D) patients were divided into 3 groups according to their serum glucose: good-controlled group(group A,12 patients),acceptable-controlled group(group B,18 patients),and uncontrolled group(group C,23 patients).Thirty healthy people were chosen as control.All cases received sagittal T1-weighted MR examination.The signal intensity ratio(SIR) of the posterior lobe to the pons on a MR T1-weighted images was calculated.SIRs between T2D groups and control group were compared.Follow-up MR examinations were performed on 5 patients in group C in 2~3months after diabetes was controlled,and the SIRs before and after treatment were compared.The serum content of antidiuretic hormone(ADH) was evaluated in group C.The Correlation between SIR of the posterior lobes and ADH serum content was determined with Pearson ′s correlation coefficient.Results: There was no significant difference of SIR in control group with those in groups A and B(P=0.078,P=0.061);The mean SIR of group C was lower than that of control group(P=0.000).There was no significant difference of SIR between group A and group B(P>0.05);The mean SIR of groups A and B were all higher than that of group C(P<0.05,P<0.05);The mean SIR in 5 cases of C group before and after diabetic control were 1.12±0.14,and 1.23±0.11 respectively,and the one after diabetic control was higher than that before(P<0.05).Conclusions: There is no significant decrease of ADH content in pituitary posterior lobe in well controlled and relatively controlled T2D patients,while it significantly decreases in not controlled T2D patients.The signal intensity of T1WI on pituitary posterior lobe could relatively reflect the hypothalamic-pituitary function,suggesting patient's prognosis to some extent,and provide some helpful information for clinic treatment.

关键词(KeyWords): 2型糖尿病;垂体,后叶;磁共振成像;抗利尿激素
type 2 diabetes mellitus;pituitary gland,posterior lobe;magnetic resonance imaging;antidiuretic hormone

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作者(Author): 华俊;张余;王学建;
HUA Jun1,ZHANG Yu2,WANG Xuejian3(1.Radiology Department of Chongqing Cancer Institute,Chongqing 400030,China;2.Radiology Department of Southwest Hospital of the Third Military Medical University,Chongqing 400038,China;3.Radiology Department of Guihang Guiyang Hospital,Guiyang 550009,Guizhou,China)

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DOI: 10.19367/j.cnki.1000-2707.2013.03.011

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