失语症患者磁共振灌注成像特点及其发病机制分析  

Studies of the Mechanisms of Aphasia after Acute Ischemic Stroke with Perfusion Weighted Imaging

作　　者：张玉梅[1] 王丽敏[1] 曹京波[1] 陈红燕[2] 

机构地区：[1]首都医科大学附属北京天坛医院神经内科,北京市100050 [2]首都医科大学附属北京神经外科研究所

出　　处：《中国卒中杂志》2006年第7期470-473,共4页Chinese Journal of Stroke

摘　　要：目的通过功能磁共振揭示运动性、感觉性失语患者的语言功能区血流量变化,探讨失语症可能的发病机制,为语言康复训练提供理论指导。方法对2004年2月至2005年2月在北京天坛医院神经内科住院的58例经CT或MRI证实为脑梗死且符合病例入选标准及排除标准的患者,采用西部失语成套测验评定标准判断失语症类型。对运动性或感觉性失语患者病变可能波及的Broca区、Wernicke区进行磁共振灌注成像(perfusion weighted imaging,PWI)分析,主要测量Broca区或Wernicke区的局部脑血流量、局部脑血容量、对比剂平均通过时间、达峰时间,并与对侧镜像区进行对比。结果在符合入选标准的58例脑梗死患者中,经西部失语成套测验评定12例为运动性失语、21例为感觉性失语,其他失语症类型25例。对12例运动性失语、21例感觉性失语患者的PWI结果进行统计学分析,提示患者受累语言功能区处于低灌注状态。结论失语症患者急性期语言功能区均呈低灌注表现,这可能为失语症的发病机制之一。Objective To approach aphasia pathogenesis by observing perfusion changes of language areas on functional magnetic resonance in order to provide theory instruction to language rehabilitation of aphasia patients. Methods Between February 2004 and February 2005, the in-patients in the Neurology Department of Beijing Tiantan Hospital, who had been diagnosed with cerebral ischemia by computer tomography (CT) or magnetic resonance imaging(MRI) and had language disorders were selected for this study. We decided the aphasia types by the Western Aphasia Battery .The Broca’s aphasia and Wernicke’s aphasia patients were taken perfusion weighted imaging (PWI) to measure the Broca’s or Wernicke’s areas regional cerebral blood volume (rCBV), regional cerebral blood flow (rCBF), mean transit time (MTT) and time to peak (TTP),also to compare the results with that of the mirror hemisphere. Results Total 58 patients were enrolled in our study in which there were 12 Broca’s aphasia cases , 21 Wernicke’s aphasia cases and 25 other aphasia types cases. The results of PWI showed that Broca’s or Wernicke’s areas were in a state of hypoperfusion compared with that of the mirror hemisphere, with significant differences between them. Conclusion Broca’s area and Wernicke’s area of Broca’s and Wernicke’s aphasia patients are in a state of hypoperfusion which may be one of the mechanisms of aphasia.

关 键 词：语言中枢 失语症 低灌注 

分 类 号：R743.3[医药卫生—神经病学与精神病学]