Objective To explore whether the combined amide proton transfer weighted imaging(APTw)and apparent diffusion coefficient(ADC)can diagnose the presence of the ischemic penumbra in cerebral infarction lesions in patients with type 2 diabetes mellitus(T2DM).Methods A retrospectively collected T2DM patients with cerebral infarction who underwent DWI,APT and conventional sequence head MRI examinations and divided into the DWI and APTw image mis-match group and the non-mismatch group.The APTwm and ADCm of the infarction lesions were measured.The statistical differences in imaging and clinical parameters between the two groups were analyzed.The receiver operating characteristic curve(ROC)was used to analyze the diagnostic efficacy of parameters and combined diagnostic parameters.The Delong test was used to analyze the statistical differences among the ROC results.Results There was a statistically significant difference in APTwm between the two groups(P=0.00),while there was no statistically significant difference in ADCm,age,gender,Hb Alc,hyperlipidemia,hypertension,smoking history,and drinking history between the two groups(P＞0.05).ROC analysis showed that APTwm alone and the combined diagnosis of APTwm combined with other parameters had diagnostic efficacy,and the combined diagnostic efficacy of APTwm+clinical parameters was the highest(AUC=0.869).The Delong test showed that there was no statistically significant difference among the ROC results(P＞0.05).Conclu-sion APTwm has diagnostic efficacy for the presence of the ischemic penumbra in cerebral infarction lesions in T2DM pa-tients.The combined diagnostic efficacy of APTwm with clinical parameters is the highest,but there is no statistically signifi-cant difference from the diagnostic efficacy of APTwm alone.
Type 2 diabetes mellitusCerebral infarctionIschemic penumbraApparent diffusion coefficientAm-ide proton transfer imaging
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