应用扩散张量纤维束成像技术评价弓状束在语言功能及功能障碍预后评估中的作用  

Role of arcuate fascicle in language function and prognosis of language dysfunction: An evaluation by diffusion tensor tractography

作　　者：孙学进[1] 王欣[2] 顾青[1] 张玉梅[3] 田伟[1] 沈进[1] 戴建平[4] 

机构地区：[1]昆明医学院第一附属医院磁共振室,云南省昆明市650032 [2]中山大学中山医学院 [3]首都医科大学北京天坛医院神经内科,北京市100050 [4]首都医科大学北京天坛医院神经影像中心,北京市100050

出　　处：《中国组织工程研究与临床康复》2007年第48期9621-9626,共6页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:利用磁共振扩散张量成像及扩散张量纤维束成像技术观察正常人及失语症患者弓状束结构特点,探讨弓状束功能解剖学结构基础及其在语言功能障碍康复预后评估中的作用。方法:临床资料的收集和磁共振扫描及分析于2003-11/2005-02在北京天坛医院神经影像中心完成。选择正常人20例,失语症患者48例,其中Broca失语30例,Wernicke失语13例,传导性失语5例。应用德国西门子公司SIEMENS Trio 2003T磁共振仪及工作站完成全脑的数据收集和后处理,观察弓状纤维束的磁共振扩散张量成像部分各向异性(FA)值及纤维束的数量。结果:68例受试者均进入结果分析。①正常人:弓状束左右侧对照差异不显著(P>0.05),个体间的纤维束数量有差异;纤维束平均向异性值左侧高于右侧(P<0.05)。②Broca失语者:弓状束左侧的纤维束数量及纤维束平均FA均较右侧减少(P<0.05),左侧弓状束的平均FA较正常人组减少(P<0.05),其弓状束改变主要是前端纤维束完整性破坏和移位。③Wernicke失语者:弓状束的纤维束数量及纤维束平均FA均较正常人组减少(P<0.05),其弓状束有不同程度损伤,主要是中后部的损伤明显。④传导性失语者:弓状束的损伤主要以功能偏利侧的中部为主,其前、中和后的FA值明显低于正常人组(P<0.05)。结论:①弓状束是联系Broca区及Wernicke区间重要联合纤维束,在语言功能的完成中具有重要的作用,但个体间存在左右侧的数量及结构的差异。②失语症弓状束均有不同程度损伤,损伤部位与失语类型有关,同时弓状束损伤程度与预后密切相关。AIM： To observe the structure of arcuate fascicule in normal people and aphasia patients by diffusion tensor imaging and diffusion tensor fiber tractography, investigate the functional anatomy basis of arcuate fascicule and the effect of arcuate fascicule on evaluating prognosis of language dysfunction.METHODS： The clinical data were collected, as well as MRI scanning and analysis were carried out in the Center of Neuroradiology, Beijing Tiantan Hospital from November 2003 to February 2005.Clinical data were enrolled from 20 normal volunteers and 48 aphasia patients, including 30 Broca aphasias, 13 Wemicke aphasias and 5 conduction aphasias. Data collection and procession of the entire brain were conducted by using Germany SIEMENS Trio 2003T MRI analyzer and working station. Diffusion tensor images of arcuate fascicule were obtained to measure fractional anisotropy （FA） value and count the fascicule. RESULTS： Totally 68 subjects were involved in the result analysis.（1）Normal subjects： FA was of insignificant differences between left and right side of arcuate fascicule （P 〉 0.05）, while the fasciculus fibers were significantly different; the average FA in left side was higher than that in right side （P 〈 0.05）.（2）Broca aphasia： The arcuate fasciculus fibers and average FA of left sides was significantly higher than that in left side （P 〈 0.05）, and the average FA of left arcuate fascicule was decreased compared with normal subjects （P 〈 0.05）. The dominant damage occurred in the foreside arcuate fascicule by destruction and displacement. （3）Wernicke aphasia： Arcuate fibers and average FA of both sides were reduced compared with normal subjects （P 〈 0.05）. The left arcuate fascicule was integrality damaged, especially the middle and posterior parts of arcuate.（4）Conduction aphasia： The damage was mostly middle part of the laterality. FA value was obviously decreased compared with normal subjects （P 〈 0.05）. CONCLUSION： （1）The arcuate fascic

关 键 词：扩散张量成像 扩散张量纤维束成像 弓状束 BROCA区 Wemicke区 传导性失语 语言功能区 联合纤维 

分 类 号：R318.08[医药卫生—生物医学工程]