Abstract
Diabetics are prone to postoperative cognitive dysfunction (POCD). The occurrence may be related to the damage of the prefrontal lobe. In this study, the prefrontal lobe was segmented based on an improved clustering algorithm in patients with diabetes, in order to evaluate the relationship between prefrontal lobe volume and COPD. In this study, a total of 48 diabetics who underwent selective noncardiac surgery were selected. Preoperative magnetic resonance imaging (MRI) images of the patients were segmented based on the improved clustering algorithm, and their prefrontal volume was measured. The correlation between the volume of the prefrontal lobe and Z-score or blood glucose was analyzed. Qualitative analysis shows that the gray matter, white matter, and cerebrospinal fluid based on the improved clustering algorithm were easy to distinguish. Quantitative evaluation results show that the proposed segmentation algorithm can obtain the optimal Jaccard coefficient and the least average segmentation time. There was a negative correlation between the volume of the prefrontal lobe and the Z-score. The cut-off value of prefrontal lobe volume for predicting POCD was <179.8, with the high specificity. There was a negative correlation between blood glucose and volume of the prefrontal lobe. From the results, we concluded that the segmentation of the prefrontal lobe based on an improved clustering algorithm before operation may predict the occurrence of POCD in diabetics.
Highlights
More and more evidence shows that the type 2 diabetes mellitus (T2DM) can cause damage to the function and integrity of brain tissue [1,2,3,4]
Qualitative analysis shows that the gray matter, white matter, and cerebrospinal fluid based on the improved clustering algorithm were easy to distinguish
There was no significant difference between the postoperative cognitive dysfunction (POCD) and non-POCD groups, which indicated that the preoperative state of patients and the effect of anesthesia on the two groups were basically the same
Summary
More and more evidence shows that the type 2 diabetes mellitus (T2DM) can cause damage to the function and integrity of brain tissue [1,2,3,4]. Cognitive damage is one of the manifestations of brain damage, and the damage of cognitive function is accompanied by the change of brain tissue structure [5, 6]. Postoperative cognitive dysfunction (POCD) is a common complication of anesthesia operation [9], which often occurs in the elderly [10]. The incidence of POCD is higher because of the possible brain damage in diabetic patients [11]. POCD affects the patients’ quality of life after operation and leads to an increased incidence of postoperative pulmonary infection and death [12]. There is no effective index to predict the occurrence of POCD [13]
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