磁共振弥散加权像检查纹状体内囊梗死后失语的回顾性分析  

Retrospective analysis on aphasia following stratocapsular infarction using magnetic resonance diffusion-weighted imaging

作　　者：李轶[1] 龚浠平[1] 王拥军[1] 

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

出　　处：《中国临床康复》2006年第30期40-41,50,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:分析纹状体内囊梗死急性期失语与非失语患者磁共振弥散加权像检查结果差异,观察不同失语类型患者皮质病灶部位。方法:①于2003-06/2005-10在北京天坛医院神经内科住院治疗的发病24h之内的急性大脑中动脉梗死患者152例。均符合第四次全国脑血管病会议拟订的脑梗死诊断标准;在发病48h内接受了常规核磁共振,核磁弥散像和磁共振血管成像检查;对检查项目知情同意。符合上述纳入标准的患者78例,其中38例患者在灌注核磁上出现了纹状体内囊梗死灶,以38例中纹状体内囊梗死病灶位于优势半球左半球,且均为右利手的患者21例为观察对象,男12例,女9例,平均年龄(56±11)岁。②所有观察对象在卒中发病4d内使用西部失语成套测验进行失语的评估。采用MRI诊断仪(西门子trio3.0T)对患者进行T1,T2,弥散及灌注成像扫描,以及动脉磁共振成像扫描。③计数结果差异比较采用χ2检验(Fisher’s确切概率法)。结果:纳入急性大脑中动脉梗死患者78例,38例患者出现纹状体内囊梗死灶,38例中纹状体内囊梗死病灶位于优势半球左半球,且为右利手的21例患者进入结果分析。①磁共振弥散回权像检查结果:9例(42%)左侧纹状体内囊梗死的失语患者除纹状体内囊梗死外均存在同侧皮质的缺血病灶,而另外12例无失语的患者中仅3例(21%)出现了纹状体内囊梗死以外的皮质病灶,两者差异明显(P=0.001);其余9例无失语的患者在弥散核磁像仅发现了左侧半球的纹状体内囊梗死。②常规MRI检测结果:未发现失语患者的急性期皮质损害病灶。③磁共振弥散加权像所示皮质病灶部位与失语类型的关系:3例完全性失语患者均出现了颞叶后部的损害,2例出现了额叶前部和顶叶下部的病灶。4例运动性失语的患者中3例出现了岛叶或额叶的病灶,2例出现了顶叶或颞叶的病灶。2例感觉性失语的患者均出现了顶�AIM： To analyze the difference in results of diffusion-weighted imaging （DWI） for patients with aphasia and non-aphasia following striatocapsular infarction （SCI）, and investigate the localization of the infarction in patients with different aphasia types. METHODS： ①152 patients with acute middle cerebral artery infarction in 24 hours hospitalized in Department of Neurology, Beijing Tiantan Hospital from June 2003 to October 2005 were selected. Their disease was accorded with the criteria of cerebral infarction on the 4^th national cerebral vaseular disease eonferenee; all patients informed and agreed to the deteetion were given magnetic resonance imaging （MRI）, DWI, and magnetic resonance angiography （MRA） within 48 hours after onset. Totally 78 patients were recruited into this study, 38 of them showed SCI on the PWI, and 21 of the 38 patients＇ SCI located on the left hemisphere with right handedness were selected as objects including 12 males and 9 females with average age of （56±11） years. ②Aphasia Was assessed by the West Aphasia Battery （WAB） in 4 days after onset. Simens trio3.0T was fised to perform the T1, T2, DWI, PWI and MRA. ③χ^2 test （Fisher＇s exact test） was used to compare the difference between the counted results. RESULTS： The 78 patients with acute middle cerebral artery infarction were recruited, 38 of them showed SCI on the PWI, and 21 of the 38 patients＇ SCI located on the left hemisphere with right handedness were involved in the result analysis. ①DWI results： 9 SCI patients （42%） of the 21 ones presented additional ischemic lesions involving the same side cortical areas; while 3 non-aphasia cases （21%） of 12 ones had additional cortical lesions, there were significant differences between them （P=0.001）, all the rest 9 non-aphasia patients had SCI on the left hemisphere in DWI.② Conventional MRI results： No corresponding acute cortical lesions was found in any aphasic patients.③ Relation between cortical lesions and aphasi

关 键 词：磁共振成像/方法 失语 脑梗塞 

分 类 号：R767.64[医药卫生—耳鼻咽喉科]