目的 探讨腹腔内脏脂肪含量与糖尿病发生的关系，进而探讨其预测T2DM发病的可行性。 方法 收集行腹部3.0T MRI检查并有T2DM患者45例（T2DM组），对照组80例，应用IDEAL软件进行图像自动重组，获得脂肪分数（FF图）、弛豫率（R2^*）、脂相、水相、同反相位图像。将FF图传至AW 4.6工作站，由两名观察者采用双盲法对FF图进行测量。应用ITK-SNAP软件采用阈值分割法半自动勾画腹腔内脏脂肪（VAT）及皮下脂肪组织（SAT），并计算体积。采用SPSS 26.0软件对数据进行统计学分析。 结果 （1）T2DM组的腹腔内脏脂肪组织体积（VATV）、肝脏脂肪分数（HFF）、胰腺脂肪分数（PFF）、甘油三酯（TG）及空腹血糖（FBG）均高于对照组，高密度脂蛋白（HDL）低于对照组，差异有统计学意义（P < 0.05）；（2）ROC曲线分析示：PFF判断是否患T2DM的曲线下面积（AUC）为0.656（P < 0.01，95%CI：0.534 ~ 0.777），截断值为8.44%，敏感度为50%，特异度为82.5%；HFF判断是否患T2DM的AUC为0.744（P < 0.05，95%CI：0.637 ~ 0.851），截断值、敏感度、特异度分别为2.99%、97.5%、42.5%。男性患者VATV判断T2DM的最佳阈值为3 466 cm3，敏感度为63.2%，特异度为89.5%，AUC为0.78（P < 0.01），联合SATV、PFF及HFF时，敏感度为78.9%，特异度为84.2%，AUC为0.839（P < 0.01）；女性患者利用VATV诊断T2DM的最佳阈值为2 103 cm3，利用该阈值判断T2DM的敏感度为66.7%，特异度为66.7%，AUC为0.68（P < 0.05），联合SATV、PFF及HFF时，敏感度为90.5%，特异度为76.2%，AUC为0.909（P < 0.01）。（3）TG和FBG每增加1个单位，患T2DM的风险就分别提升了3986.3%及417.1%，即TG和FBG是T2DM发病的独立预测因子。 结论 PFF、HFF及VATV单独在预测T2DM发病方面，检验效能较低。VATV联合SATV、PFF、HFF预测T2DM发生的检验效能显著提高，其敏感度及特异度亦均明显提高。IDEAL-IQ技术是评估T2DM患者腹腔内异位脂肪组织沉积定量的便捷的方法，具有简单、稳定性好及重复性高的优势。

Objective To investigate the association between abdominal visceral fat content and the occurrence of type 2 diabetes mellitus （T2DM） and the potential of predicting the incidence of T2DM with abdominal visceral fat content. Methods The study included 45 patients with T2DM who underwent 3.0T MRI and 80 control patients， recruited from the First Affiliated Hospital of Baotou Medical College， Inner Mongolia University of Science and Technology. IDEAL software was utilized for automated image recombination to obtain fat fraction， relaxation rate （R2^*）， lipid phase， water phase， and in-phase images. Fat fraction images were transferred to AW 4.6 workstation for measurement of fat fraction plots by two observers using a double-blind approach. ITK-SNAP software was employed for semi-automatic delineation of abdominal visceral fat and subcutaneous adipose tissue through threshold segmentation method， followed by volume calculation. Statistical analysis of the data was performed using SPSS 26.0 software. Results （1） The T2DM group exhibited significantly higher levels of abdominal visceral adipocyte volume （VATV）， hepatic fat fraction （HFF）， pancreatic fat fraction （PFF）， triglyceride （TG）， and fasting blood glucose （FBG） compared to the control group. Conversely， the high density lipoprotein （HDL） level was significantly lower in the T2DM group than in the control group （P < 0.05）. The correlation analysis revealed that in male patients， abdominal VATV exhibited positive associations with body mass index （BMI）， waist circumference， subcutaneous adipose tissue volume （SATV）， hepatic fat fraction （HFF）， TG， and FBG； while displaying a negative association with HDL. In female patients， VATV demonstrated positive correlations with BMI， waist circumference， SATV， and HFF. （2） The ROC curve analysis demonstrated that the area under the curve （AUC） for PFF in diagnosing T2DM was 0.656 （P < 0.01，95%CI：0.534 ~0.777）. The determined cut-off value was 8.44%， yielding a sensitivity of 50% and specificity of 82.5%. Similarly， HFF exhibited an AUC of 0.744 （P < 0.05， 95%CI： 0.637 ~ 0.851）， with a cut-off value of 2.99%， sensitivity of 97.5%， and specificity of 42%. In male patients， VATV displayed an optimal threshold for T2DM diagnosis at a volume of approximately 3 466 cm3， resulting in a sensitivity of 63.2%， specificity of 89.5%， and AUC of 0.78 （P < 0.01）. The sensitivity was 78.9% and specificity was 84.2% when SATV， PFF and HFF were combined and the AUC was 0.839 （P < 0.01）. The optimal threshold for diagnosing T2DM with VATV in female patients was 2 103cm3， and the sensitivity， specificity and AUC of T2DM with VATV were 66.7%， 66.7% and 0.68 （P < 0.05）. When SATV， PFF and HFF were combined， the sensitivity was 90.5%. The specificity was 76.2% and the AUC was 0.909 （P < 0.01）. （3）For each additional unit of TG and FBG， the risk of T2DM respectively increased by 3986.3% and 417.1%， in other words， TG and FBG were independent predictors of the occurrence of T2DM. Conclusion The predictive value of pancreatic fat fraction， liver fat fraction， and abdominal visceral fat tissue volume for the onset of type 2 diabetes is limited. However， combining abdominal visceral adipose tissue volume with subcutaneous adipose tissue volume， pancreatic fat fraction， and liver fat fraction significantly enhances the efficacy， sensitivity， and specificity of predicting type 2 diabetes occurrence. The IDEAL-IQ technique offers a convenient method for quantitatively evaluating intra-abdominal ectopic adipose tissue deposition in patients with type 2 diabetes mellitus. It demonstrates advantages such as simplicity， good stability， high reproducibility and holds great potential.