Evaluation of Coronary Artery Disease Patients with and without Type II Diabetes by Using Dynamic MR Perfusion of Pancreas and Proton MR Spectroscopy of Muscle and Liver
Date Issued
2007
Date
2007
Author(s)
DOI
zh-TW
Abstract
The pathophysiology of type 2 diabetes is complex and still partially unknown. The defect of insulin secretion and the peripheral insulin resistance are both necessary in the development of type 2 diabetes. Insulin resistance appears early in the course of the disease, but the secrete defect is the key factor in the transformation from the initial stage into type 2 diabetes. Thus as potential therapeutic implications are considered, it is not only important to reduce the insulin resistance and improve the insulin sensitivity but also promote the beta-cell survival and keep it from secretory dysfunction.
In clinical application of diagnosis, treatment and prevention, we measure the serum insulin concentration in order to access the function of insulin secretion. We could not measure the beta-cell mass or islet blood flow in the pancreas directly by any of the present image modality. The islet blood flow or its viability could only be accessed by tissue proof from biopsy or operation. Only animal study had been mentioned and the data in human is to be obtained. Thus, it is important to develop a method to measure the in vivo pancreatic blood flow or tissue perfusion by a non-invasive and reproducible method in human subjects. We apply MR dynamic-perfusion technique on the pancreas to access the relationship between the tissue perfusion and its function.
On the other hand, as insulin resistance acts on the liver, muscle and adipose tissue, it results in abnormal fat deposition in these structures. Insulin resistance of the liver and muscle often appears earlier than the adipose tissue, thus liver and muscle may pile up abnormal fat in the initial stage before patients become overt obese. We apply MR spectroscopy technique to measure the lipid component in the liver and muscle in order to evaluate the relationship between the distribution of lipid and clinical information of type 2 diabetes.
The metabolic syndrome emphasized the association between DM, obesity, hypertension and atherosclerosis. Thus we aim to investigate the difference of MR perfusion of pancreas and proton MR spectroscopy of muscle and liver between subjects, who are documented CAD, with and without type 2 diabetes.
Among subjects with documented CAD, the obtained data demonstrate that 1) the MR perfusion of pancreas in subjects with type 2 diabetes is significantly decreased than in subjects without diabetes, even after adjusted with their age, BMI, and severity of CAD; 2) the intramyocellular lipid is found higher in subjects with type 2 diabetes than in subjects without diabetes and is also higher in subjects with poor blood sugar control than in subjects with better control; 3) although higher intrahepatocellular lipid is not shown in the subjects with type 2 diabetes, the well correlation between the intrahepatocellular lipid and the serum TG makes the feasibility of clinical utility of liver MRS in the detection of fatty liver.
Subjects
核磁共振組織灌注
氫磁振頻譜
第二型糖尿病
冠狀動脈疾病
MR perfusion
MR spectroscopy
type 2 diabetes
coronary artery disease
SDGs
Type
text
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