Abstract: Objective　To discuss application of multimodal MRI combined with inflammatory factors in evaluating the morphological changes of the sciatic nerve of diabetic rabbits.Methods　Sixty eight New Zealand white rabbits were divided into normal control group (n=8) and model group (n=60) by a random number table. The model included the diabetes (DM) group (n=20) and diabetes peripheral neuropathy (DPN) group (n=40). The multimodal MRI findings, microcirculation factors (VEGF), tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) of three groups were compared.Results The levels of VEGF, TNF-α, CRP of DM group and DPN group were significantly higher than that in the control group, while the levels of VEGF, TNF-α and CRP of the DPN group were significantly higher than that in the DM group (P<0.05). The cross-sectional area of nerves in both the DM and DPN groups were significantly higher than that in the control group, and the cross-sectional area of nerves in the DPN group was significantly higher than DM group (P<0.05). The conduction velocity of neural action potentials of DM group and DPN group were significantly lower than control group, and the conduction velocity of neural action potentials of DPN group was significantly lower than the DM group (P<0.05). The three-dimensional arterial spin labeling (3D-ASL), diffusion tensor imaging (DTI) and magnetic resonance functional imaging non-invasive quantitative evaluation indicators of cerebral blood flow (CBF) and anisotropy score (FA) of DM group and DPN group were significantly higher than those in the normal control group, with statistical significance (P<0.05). The non-invasive quantitative evaluation indicators CBF and FA values of 3D-ASL and DTI magnetic resonance functional imaging of DPN group were significantly higher than those in DM group, with statistical significance (P<0.05). The combined detection of multimodal MRI with VEGF, TNF-α and CRP had an area under the curve (AUC) value of 0.964, sensitivity of 95.00% and specificity of 95.00%, which were higher than the detection of CBF value, FA value, VEGF, TNF-α and CRP alone.Conclusion　The dynamic changes of serum VEGF, TNF-α and CRP levels in diabetes rabbits, combined with the changes of 3D-ASL and DTI functional magnetic resonance imaging parameters, can effectively reflect the stage evolution of sciatic nerve cell morphology. This multimodal non-invasive quantitative evaluation strategy provides objective and reproducible imaging evidence for early identification and staging diagnosis of sciatic nerve lesions in DPN rabbit models.

Key words: diabetes, sciatic nerve cells, inflammatory factors, multimodal MRI, correlation

摘要： 目的　探讨多模态MRI结合炎性因子在评价糖尿病兔坐骨神经形态改变中的应用。方法　采用随机数字表 法将68只新西兰白兔分为健康对照组(8只)和模型组(60只),模型组包括糖尿病(DM)组(20只)和糖尿病周围 神经病变(DPN)组(40只)。比较三组多模态MRI检查结果、微循环因子(VEGF)、肿瘤坏死因子-α(TNF-α)及C 反应蛋白(CRP)水平。结果　DM组与DPN组VEGF、TNF-α及CRP水平显著高于健康对照组;DPN组VEGF、 TNF-α及CRP水平显著高于DM组,差异均有统计学意义(P<0.05)。DM组与DPN组神经横截面面积显著高于 健康对照组,DPN组神经横截面面积显著高于DM组,差异均有统计学意义(P<0.05)。DM组与DPN组神经动作 电位传导速度显著低于健康对照组,DPN组神经动作电位传导速度显著低于DM组,差异均有统计学意义(P< 0.05)。DM组与DPN组三维动脉自旋标记(3D-ASL)、弥散张量成像(DTI)磁共振功能成像无创定量评估指标脑 血流量(CBF)值、各向异性分数(FA)值显著高于健康对照组,差异有统计学意义(P<0.05);DPN组3D-ASL、DTI 磁共振功能成像无创定量评估指标CBF值、FA值显著高于DM组,差异有统计学意义(P<0.05)。多模态MRI与 VEGF、TNF-α、CRP联合检测的曲线下面积(AUC)为0.964,灵敏度为95.00%,特异度为95.00%,高于应用CBF 值、FA值、VEGF、TNF-α、CRP单独检测。结论　DM兔血清VEGF、TNF-α及CRP水平的动态变化,联合3D-ASL与 DTI磁共振功能成像参数的改变,可有效反映坐骨神经细胞形态学的阶段性演变。该多模态无创定量评估策略为 DPN兔模型中坐骨神经病变的早期识别与分期诊断提供了客观、可重复的影像学依据。

关键词: 糖尿病, 坐骨神经细胞, 炎性因子, 多模态MRI, 相关性