弓状纤维束在缺血性卒中患者传导性失语中的作用：弥散张量纤维束成像研究  

Role of arcuate fasciculus in conduction aphasia in patients with ischemic stroke：A diffusion tensor tractography study

作　　者：李闯[1] 李华[1] 陈营[1] 

机构地区：[1]石河子大学医学院第三附属医院神经医学中心,832000

出　　处：《国际脑血管病杂志》2016年第5期418-421,共4页International Journal of Cerebrovascular Diseases

基　　金：国家自然科学基金（31260235）

摘　　要：目的：应用磁共振弥散张量成像（diffusion tensor imaging, DTI）技术探讨弓状纤维束在急性缺血性卒中后传导性失语中的作用。方法选择5例急性缺血性卒中后传导性失语症患者（病例组）和5例无失语者（对照组）,应用 DTI 技术检测 Broca 区、Wernicke 区、弓状纤维束各向异性分数（fractional anisotropy, FA）。结果对照组左侧半球 Broca 区（0．341±0．018对0．295±0．060；t =4．533,P =0．045）、Wernicke 区（0．303±0．009对0．243±0．011；t =6．556,P =0．022）和弓状纤维束（0．646±0．020对0．541±0．009；t =7．343,P =0．018）FA 值均显著高于其镜像区。病例组左侧半球 Broca 区（0．315±0．015对0．280±0．006； t =6．246, P =0．023）、 Wernicke 区（0．299±0．012对0．239±0．022；t =4．576,P =0．025）和弓状纤维束（0．226±0．016对0．294±0．007；t =-12．590,P =0．006）FA 值亦显著高于其镜像区。病例组左侧半球 Broca 区（t =1．901,P =0．13）和 Wernicke 区（t =2．092,P =0．105）FA 值与对照组左侧半球差异无统计学意义,但弓状纤维束 FA 值显著低于对照组（t =28．393,P 〈0．001）。结论急性缺血性卒中后传导性失语症患者,弓状纤维束存在左侧偏侧优势,其传导性失语可能与弓状纤维束的减少和断裂有关。Objective To investigate the role of arcuate fasciculus in conduction aphasia after ischemic stroke using magnetic resonance diffusion tensor imaging （DTI） technique. Methods Five patients with conduction aphasia after acute ischemic stroke （case group） and 5 patients without aphasia （control group） were selected. The DTI technique was used to detect the fractional anisotropy （FA） of Broca＇s area, Wernicke＇s area, and arcuate fasciculus. Results The FA values of Broca＇s area （0. 341 ± 0. 018 vs. 0. 295 ± 0. 060; t = 4. 533, P = 0. 045）, Wernicke＇s area （0. 303 ± 0. 009 vs. 0. 243 ± 0. 011; t = 6. 556, P = 0. 022）, and arcuate fiber bundle （0. 646 ± 0. 020 vs. 0. 541 ± 0. 009; t = 7. 343, P = 0. 018） in the left hemisphere were significantly higher compared with their mirror areas in the control group. The FA values of Broca＇s area （0. 315 ± 0. 015 vs. 0. 280 ± 0. 006; t = 6. 246, P = 0. 023）, Wernicke＇s area （0. 299 ± 0. 012 vs. 0. 239 ± 0. 022; t = 4. 576, P = 0. 025）, and arcuate fiber bundle （0. 226 ± 0. 016 vs. 0. 294 ± 0. 007; t = - 12. 590, P = 0. 006） in the left hemisphere were significantly higher compared with their mirror areas in the case group. There was no significant difference Broca＇s area （t = 1. 901, P = 0. 13） and Wernicke＇s area （t =2. 092, P = 0. 105） in the left hemisphere between the case group and the control group, but the FA values of arcuate fasciculus in the left hemisphere in the case group was significantly lower compared with the control group （t = 28. 393, P 〈 0. 001 ）. Conclusions For patients with conduction aphasia after acute ischemic stroke, the arcuate fasciculus has the left-dominant lateralization. Their conduction aphasia may be associated with the reduction and break of the arcuate fasciculus.

关 键 词：卒中 脑缺血 失语 传导性 弥散张量成像 神经通路 

分 类 号：R743.3[医药卫生—神经病学与精神病学]