累及Broca区低级别胶质瘤的BOLD-fMRI及语言功能区的可塑性研究(附15例分析)  

Bold-fMRI in low-grade gliomas involving Broca area:plasticity of language functions

作　　者：吴陈兴[1] 魏淼[2] 仪晓立[2] 浦松[3] 王永志[1] 江涛[1] 王晓怡[4] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,北京100050 [2]首都医科大学附属北京天坛医院神经影像中心,北京100050 [3]哈尔滨医科大学第一附属医院神经外科,黑龙江哈尔滨150001 [4]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10-13,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金："十一五"国家科技支撑计划(编号:2007BA105B08);首都医学发展科研基金(编号:2005-2024)

摘　　要：目的探讨Bold-fMRI在功能区低级别胶质瘤中的应用及语言功能区的可塑性。方法对15例低级别胶质瘤及14例正常人行fMRI检查并作体素分析。病人在功能影像、术中电刺激指导下进行手术,结合语言测评、影像评估及Karnofsky功能状态评分(KPS)等进行随访。结果病人较正常人半球激活指数(HAI)低,提示语言功能区重塑。肿瘤全切除11例,近全切除4例。术后短期内有不同程度失语7例,术后3个月均得以恢复。术后KPS评分较术前提高。结论Broca区低级别胶质瘤病人术前、术后语言功能区具有可塑性;应用术前功能影像及术中电刺激指导手术治疗,可提高肿瘤的切除程度,同时亦可保护语言功能。Objective To investigate the significance of blood oxygenation level dependent-fMRI （Bold-fMRI） in low-grade gliomas within Broca area, focusing on plasticity of language function area. Methods Fifteen patients and 14 healthy subjects were enrolled in this experiment and received conventional MRI and fMRI language evaluation with a statistical analysis. The resections were guided by fMRI and intraoperative electrical stimulation for functional mapping. The patients were followed up by postoperative speech evaluation, fMRI and quality-of-life assessment. Results The lower hemispheric activation index in the patients than healthy subjects suggested plasticity of language function. Total and subtotal tumor resections were achieved in 11 and 4 patients, respectively. Postoperatively, 7 patients had aphasia to varying extents in short term, but recovered to normal 3 months later. All patients recovered and returned to a normal socioprofessional life （KPS score of 90-100）. Conclusion Language function area has the plasticity in patients with low-grade glioma. Combination of fMRI and language mapping techniques can improve resection of tumor and protect the language function of the patient.

关 键 词：神经胶质瘤 额叶 失语 脑可塑性 磁共振成像 体素分析法 

分 类 号：R739.4[医药卫生—肿瘤]