颈动脉狭窄对脑梗死后BOLD信号的影响  

The preliminery study of the influences of carotid artery stenosis on BOLD signal

作　　者：安荷娣[1] 黄东雅[1] 余飞[1] 裴孟超[2] 李建奇[2] 

机构地区：[1]同济大学附属东方医院神经内科,上海200120 [2]华东师范大学物理系,上海200062

出　　处：《同济大学学报（医学版）》2010年第5期52-55,共4页Journal of Tongji University(Medical Science)

摘　　要：目的探讨颈动脉狭窄对脑梗死患者恢复期BOLD-fMRI信号变化的影响。方法采用3.0T超导磁共振机对17例急性脑梗死患者(病例组)和13例正常志愿者(对照组)进行BOLD-fMRI研究。病例组颈动脉狭窄者(>50%)8例,无明显颈动脉狭窄者(<50%)9例,所得结果采用SPM5进行图像后处理。结果功能磁共振显示,激活部位主要分布在主要感觉运动区(primary sensorimotor cortex,SM1),辅助运动区(supplementary motor area,SMA)及小脑等部位。根据Brodmann分区,得出脑梗死患者激活体素为(471.86±396.04)mm3,较正常对照组(278.14±149.36)mm3明显增多(P<0.05),且健侧(253.80±216.33)mm3激活明显(P<0.05)。病例组颈动脉狭窄者(>50%)患侧脑Brodmann4区激活体素为(26.74±23.49)mm3,明显小于无明显颈动脉狭窄者的激活体素(66.23±30.88)mm3(P<0.05)。结论脑梗死患者脑激活总体素明显增多,且健侧激活更为明显;颈动脉明显狭窄可降低脑内BOLD-fMRI激活体素。Objective To investigate the influences of carotid stenosis on BOLD-fMRI during acute cerebral infarction.Methods 3.0T superconductive magnetic resonance was used in this study.Seventeen acute cerebral infarction patients were enrolled including 8 cases of carotid stenosis（50%） and 9 other cases without stenosis.Thirteen healthy volunteers were selected as control.All the images were amended with statistical parametric mapping 5（SPM5）.Results The results from functional magnetic resonance imaging showed that the activation sites were mainly distributed in the main sensory motor area（primary sensorimotor cortex,SM1）,supplementary motor area（supplementary motor area,SMA）,cerebellum and other parts.According to Brodmann subarea,the total activation voxels in patients with cerebral infarction was（471.86±396.04）mm3,markedly increased compared to（278.14±149.36）mm3 in normal controls（P0.05）,especially the activation of contralateral site（253.80±216.33） mm3（P0.05）.Activation voxels in Brodmann 4 area in patients with carotid stenosis（50%）,however,was（26.74±23.49）mm3 much lower than those without significant carotid stenosis（66.23±30.88）mm3（P0.05）.Conclusion The total activation voxels especially in the unaffected hemisphere in patients with cerebral infarctions significantly increased.Carotid stenosis can reduce BOLD activation voxels in the affected hemisphere.

关 键 词：脑卒中 颈动脉狭窄 FMRI 

分 类 号：R743[医药卫生—神经病学与精神病学]