弓状束纤维示踪与功能磁共振成像定位额叶语言皮质的比较研究  

Multimodal techniques for the localization of the primary language cortex in the frontal lobe： comparison between fiber tracking of arcuate fascicle and functional MRI activation

作　　者：章捷[1] 路俊锋[1] 吴劲松[1] 姚成军[1] 庄冬晓[1] 邱天明[1] 龚秀[1] 毛颖[1] 周良辅[1] 

机构地区：[1]复旦大学附属华山医院神经外科,上海200040

出　　处：《中华神经外科杂志》2012年第12期1192-1195,共4页Chinese Journal of Neurosurgery

基　　金：国家卫生部临床学科重点项目（2010-2012年度）;自然科学基金面上项目（81071117、81271517）;上海市卫生系统优秀人才培养计划（XBR2011022）

摘　　要：目的联合弓状束纤维示踪技术和任务态fMRI，评价弓状束终末投影定位额叶语言皮质的临床可行性。方法采用任务态fMRI定位语言皮质激活区，并纤维示踪定位弓状束终末端；将两者皮质投影在导航系统融合，比较两者吻合度。结果弓状束终末投影区域与任务态fMRI语言皮质激活区高度吻合。弓状束投影区主要位于左侧中央前回腹侧部（87．5％）及左侧额下回（75．0％）。弓状束终末投影平均半径（R1）=（12．4±5．3）mm；fMRI语言任务激活区平均半径（R2）=（10．9±4．6）mm；两者中心距离（D）=（10．6±6．9）mm。结论弓状束纤维示踪不仅可用于定位和保护皮质下语言通路，还可用于额叶语言皮质定位，并与fMRI的定位结果吻合。Objective To evaluate the feasibility of language mapping through arcuate fascicle （AF） tractography in comparison with task - related functional MRI （fMRI）. Methods 8 patients with intrinsic tumors adjacent to the frontal language cortex were studied. The language activation areas in the frontal lobe were located using language task -related fMRI. The arcuate fascicle was delineated via the fiber tracking technique. The cortical projections of the AF terminations were compared with the language activation areas. Results The results of fMRI and AF projections were consistent in all but one case. The cortical projections of AF were mainly located in the ventral part of the left precentral gyrus （87. 5% ） and the left inferior frontal gyrus （75. 0% ）. The fMRI activations were mainly located in the ventral part of the left precentral gyrus （87. 5% ）, the left middle frontal gyrus （62. 5% ） ,and the left inferior frontal gyrus （50. 0% ）. The mean projection radius of AF was （ 12. 4 ±5.3） mm and （10.9 ±4.6） mm for fMRI activations. The distance between the center of projection and the core of activation was （ 10. 6 ± 6. 9） mm. Conclusions AF tractography could be applied not only in the localization of subcortical pathway, but also in language cortex localization. It is feasible to map the primary language cortex in the frontal lobe via the fiber tracking of AF.

关 键 词：语言 BROCA区 功能磁共振成像 扩散张量成像 弓状束 

分 类 号：R445.2[医药卫生—影像医学与核医学]