Correlation between Pancreatic Microcirculation and Type 2 Diabetes in Patients with Coronary Artery Disease: Dynamic Contrast-enhanced MR Imaging

Abstract

To evaluate pancreatic perfusion by using dynamic contrast material-enhanced (DCE) magnetic resonance (MR) imaging with pharmacokinetic modeling in coronary artery disease (CAD) patients with and those without type 2 diabetes to determine which perfusion parameter alterations might be associated with type 2 diabetes. This prospective study was approved by the responsible institutional review board. Written informed consent was obtained from all patients. All patients studied had CAD documented at conventional angiography. DCE MR with a two-dimensional T1-weighted fast low-angle shot sequence in oblique axial planes was used to assess pancreatic microcirculation in patients with and those without type 2 diabetes (age +/- standard deviation, 60.8 years +/- 11.2 and 61.8 years +/- 11.2, respectively; 20 men and five women in each group). Microcirculatory quantitative parameters, including volume transfer constant (K(trans), in min(-1)), extravascular extracellular space volume per unit volume of tissue (v(e)), and plasma volume per unit volume of tissue (v(p)) were compared between groups by using independent-sample t tests. Patients with diabetes had a significantly higher K(trans) (0.977 vs 0.696, P = .031) and a lower v(p) (0.057 vs 0.084, P = .005) compared with patients without diabetes. A borderline difference in v(e) was found between the diabetes and nondiabetes groups (0.141 vs 0.103, P = .05). Among the 25 patients with diabetes, those who had the condition for more than 10 years (n = 11) had significantly higher K(trans) and v(e) than did those who had diabetes for less than 10 years (n = 14) (1.145 vs 0.783 and 0.174 vs 0.108; P = .04 and .02, respectively). DCE MR imaging demonstrated increased endothelial permeability and decreased plasma volume in the pancreas in CAD patients with type 2 diabetes; patients with a history of diabetes for more than 10 years showed further increase in endothelial permeability.