학술논문
Diffusion-weighted Magnetic Resonance Imaging in the Pancreas of Fulminant Type 1 Diabetes / 劇症1型糖尿病の発症早期における膵臓MRI所見に関する調査報告
Document Type
Journal Article
Author
Akihisa Imagawa; Akira Shimada; Daisuke Chujo; Eiji Kawasaki; Haruhiko Osawa; Hiroshi Ikegami; Hiroshi Kajio; Hiroshi Nishio; Hisafumi Yasuda; Iichiro Shimomura; Junji Kozawa; Junnosuke Miura; Kazuki Yasuda; Kazuma Takahashi; Norio Abiru; Satoshi Hayata; Shoichiro Tanaka; Takuya Awata; Tetsuro Kobayashi; Tokunaga Ayumi; Tomoyasu Fukui; Toshiaki Hanafusa; Yasuko Uchigata; Yoichi Oikawa; Yumiko Kawabata; for the consultation of Japan Diabetes Society Committee on Fulminant Type 1 Diabetes Mellitus Research; 三浦 順之助; 下村 伊一郎; 中條 大輔; 今川 彰久; 内潟 安子; 及川 洋一; 大澤 春彦; 安田 和基; 安田 尚史; 小林 哲郎; 小澤 純二; 島田 朗; 川畑 由美子; 川﨑 英二; 徳永 あゆみ; 日本人1型糖尿病の成因,診断,病態,治療に関する調査研究委員会; 早田 敏; 梶尾 裕; 池上 博司; 田中 昌一郎; 福井 智康; 粟田 卓也; 花房 俊昭; 西尾 博; 阿比留 教生; 高橋 和眞
Source
糖尿病 / Journal of the Japan Diabetes Society. 2018, 61(12):840
Subject
Language
Japanese
ISSN
0021-437X
1881-588X
1881-588X
Abstract
Abrupt disease onset and severe metabolic disorders are main characteristics of fulminant type 1 diabetes. Diffusion-weighted magnetic resonance imaging (DWI) is an imaging technique that reflects restricted diffusion in organs and can detect mononuclear cell infiltration into the pancreas at the onset of the disease. Fourteen patients with fulminant type 1 diabetes who underwent abdominal magnetic resonance imaging (MRI) were recruited for the measurement of apparent diffusion coefficient (ADC) values of the pancreas that were compared with those of 21 non-diabetic controls. The ADC values of all parts of the pancreas were significantly lower in fulminant type 1 diabetes than in controls (Head, 1.424±0.382×10−3 mm2/s vs. 1.675±0.227×10−3 mm2/s; Body, 1.399±0.317×10−3 mm2/s vs. 1.667±0.170×10−3 mm2/s; Tail, 1.336±0.247×10−3 mm2/s vs. 1.561±0.191×10−3 mm2/s; Mean, 1.386±0.309×10−3 mm2/s vs. 1.634±0.175×10−3 mm2/s) (p<0.01). The best cut-off value indicated that the sensitivity was 86 % and the specificity was 71 % when using DWI, which was also efficient in two atypical patients with fulminant type 1 diabetes without elevated levels of exocrine pancreatic enzymes or with high HbA1c levels due to the preexistence of type 2 diabetes. The ADC values were significantly correlated to plasma glucose levels and arterial pH, and tended to increase with the lapse of time. DWI may be an additional tool for making an efficient diagnosis of fulminant type 1 diabetes.