Affiliation:
1. Department of Radiology, The Second Xiangya Hospital Central South University Changsha Hunan China
2. Department of Radiology The Third Affiliated Hospital of Xinxiang Medical University Xinxiang Henan China
3. MR Application, Siemens Healthineers Ltd. Changsha China
4. MR Collaboration, Siemens Healthineers Ltd. Shanghai China
5. Circle Cardiovascular Imaging Inc. Calgary Alberta Canada
6. Department of Cardiovascular Surgery, The Second Xiangya Hospital Central South University Changsha Hunan China
7. National Clinical Research Center for Metabolic Diseases The Second Xiangya Hospital of Central South University Changsha Hunan China
8. Department of Metabolism and Endocrinology The Second Xiangya Hospital of Central South University Changsha Hunan China
9. Clinical Research Center for Medical Imaging in Hunan Province Changsha China
Abstract
BackgroundImaging techniques that quantitatively and automatically measure changes in the myocardial microcirculation in patients with diabetes are lacking.PurposeTo detect diabetic myocardial microvascular complications using a novel automatic quantitative perfusion MRI technique, and to explore the relationship between myocardial microcirculation dysfunction and fibrosis.Study TypeProspective.Subjects101 patients with type 2 diabetes mellitus (T2DM) (53 without and 48 with complications), 20 healthy volunteers.Field Strength/Sequence3.0T; modified Look‐Locker inversion‐recovery sequence; saturation recovery sequence and dual‐bolus technique; segmented fast low‐angle shot sequence.AssessmentAll participants underwent MRI to determine the rest myocardial blood flow (MBF), stress MBF, myocardial perfusion reserve (MPR), and extracellular volume (ECV), which represents the extent of myocardial fibrosis.Statistical TestsKolmogorov–Smirnov test, Shapiro–Wilk test, Kruskal–Wallis H test, Mann–Whitney U test, chi‐square test, Spearman correlation coefficient, multivariable linear regression analysis. P < 0.05 was considered statistically significant.ResultsThe rest MBF was not significantly different between the T2DM without complications group (1.1, IQR: 0.9–1.3) and the control group (1.1, 1.0–1.3) (P = 1.000), but it was significantly lower in the T2DM with complications group (0.8, 0.6–1.0) than in both other groups. The stress MBF and MPR were significantly lower in the T2DM without complications group (1.9, 1.5–2.3, and 1.7, 1.4–2.1, respectively) than in the control group (3.0, 2.6–3.5, and 2.7, 2.4–3.1, respectively), and were also significantly lower in the T2DM with complications group (1.1, 0.9–1.4, and 1.4, 1.2–1.8, respectively) than in the T2DM without complications group. A decrease in MBF and MPR were significantly associated with an increase in the ECV.Data ConclusionQuantitative perfusion MRI can evaluate myocardial microcirculation dysfunction. In T2DM, there was a significant decrease in both MBF and MPR compared to healthy controls, with the decrease being significantly different between T2DM with and without complications groups. The decrease of MBF was significantly associated with the development of myocardial fibrosis, as determined by ECV.Level of Evidence2Technical EfficacyStage 3
Funder
National Natural Science Foundation of China
Natural Science Foundation of Hunan Province