原发性进行性失语的磁共振研究(附一例病例分析)  

MRI Studies on primary progressive aphasia:a case analysis

作　　者：张玉梅[1] 王拥军[1] 管小亭[1] 柴滨[1] 张婧[1] 孙学进[1] 王晓亚[2] 

机构地区：[1]首都医科大学附属北京天坛医院,北京100050 [2]哈尔滨医科大学校部保健室,黑龙江哈尔滨150086

出　　处：《中华老年心脑血管病杂志》2005年第3期172-174,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的报道1例原发性进行性失语患者的脑内影像学特点,以探讨原发性进行性失语患者常见的病变部位,脑内血流量、代谢及语言功能区之间联系纤维的变化。方法利用西门子3.0T磁共振仪对1例确诊失语类型为感觉性失语的原发性进行性失语患者进行(1)常规磁共振;(2)磁共振灌注成像;(3)磁共振波谱分析;(4)磁共振扩散张量成像分析。结果常规磁共振成像显示左侧额叶及颞叶萎缩,功能磁共振显示左侧颞叶和额叶前部代谢较对侧明显减低,左侧颞极及额前部的血流量较对侧减低;左侧皮质脊髓束部分各向异性值及追踪到的纤维束较对侧减少,Broca区与Wernicke区之间的联系纤维与对侧相比减少。结论原发性进行性失语病变的部位主要在左侧颞叶、额叶,与对侧相应区域对比呈现低灌注、低代谢状态,Broca区与Wernicke联系纤维减少。Objectives To reveal the location of brain damage in primary progressive aphasia patient, and the changes of blood flow, metabolism and connecting fibers between linguistic function areas in brain by analysing the imaging characteristics of a case of primary progressive aphasia. Methods 3.0T SIEMENS work station-siemens was used for scanning. The data were analyzed and images were processed：（ 1 ） conventional MRI; （2） magnetic resonance spectroscopy; （3） perfusion weighted imaging ; （4） diffusion tensor imaging. Results Conventional MRI demonstrated atrophy of left temporal lobe and frontal lobe, especially left temporal pole. Functional magnetic resonance imaging showed that metabolisms and blood flow of left frontal lobe and temporal lobe reduced. FA value and traced lacertus of left corticospinal tracts were reduced as compared with those of contmlateral side and the number of fibers between Wemicke＇ s and Broca＇ s areas was decreased as compared with that of contralateml side. Conclusions Major diseased regions of primary progressive phasia were located at left temporal or frontal lobe, where hypoperfnsion and hypometabolism were found as compared with those of contmlateml side and the number of fibers between Wemicke＇ s and Broca＇ s areas was decreased. These may be the pathologic mechanisms of aphasia.

关 键 词：失语 磁共振成像 颞叶 额叶 

分 类 号：R445.2[医药卫生—影像医学与核医学]