功能区胶质瘤手术前后语言功能皮质的变化(附8例分析)  

Change of the language areas after surgery in patients with brain gliomas in eloquent brain areas

作　　者：仪晓立[1] 江涛[2] 吴陈兴[2] 魏淼[1] 王晓怡[3] 李少武[1] 陈绪珠[1] 艾林[1] 戴建平[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经影像中心,北京100050 [2]首都医科大学附属北京天坛医院胶质瘤中心,北京100050 [3]北京师范大学认知神经科学与学习国家重点实验室,北京100875

出　　处：《中国微侵袭神经外科杂志》2009年第1期3-5,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：国家自然基金面上项目(编号:30772238);国家自然基金重点项目(编号:30730035);"十一五"重点课题(编号:2007BAI05B08)

摘　　要：目的探讨功能区胶质瘤手术前后语言功能皮质的改变。方法对8例胶质瘤累及功能区的病人,在切除术前和术后3～6个月内进行听觉方式呈现的汉语词汇语义判断任务的血氧水平依赖功能性磁共振(BOLD-fMRI,3.0T)扫描,采用AFNI软件进行脑功能区活动图像分析,获得语言皮质的激活体素,计算出术前和术后的半球激活指数(HAI)并行统计学分析。结果术后3个月,病人左侧大脑半球瘤腔周围的激活明显增加。量化激活体素结果表明:术前HAI为0.96±0.22,术后1.10±0.21,两者差异有统计学意义(P<0.001)。结论手术部分切除或大部切除脑胶质瘤3个月后,左侧大脑半球的语言皮质激活体素较术前有不同程度升高。这说明语言功能皮质具有一定的可塑性。Objective To explore the change of the cortex involved in language function after surgery in patients with brain glioma in the eloquent brain areas. Methods BOLD-fMRI （3.0 T） with block-designed auditory semantic judgment task of Chinese words was performed before and 3-6 months after operation in 8 patients with brain glioma located in the eloquent areas. The live images in the eloquent brain areas were analyzed using AFNI software, A hemispheric activation index （HAI） was obtained before and after operation and compared statistically. Results The activation of the area around the tumor cavity in the left hemisphere was increased significantly 3 months after the surgery, with an HAl of 0.96±0.22 before operation and that of 1.10±0.21 after operation respectively （P〈0.001）. Conclusion Elevation of activated voxel level of the language cortex in the left cerebral hemisphere after glioma resection suggests the plasticity of language function.

关 键 词：神经胶质瘤 磁共振成像 额叶 失语 神经元可塑性 

分 类 号：R739.4[医药卫生—肿瘤]