缺血性卒中后传导性失语的磁共振扩散张量成像研究  

Magnetic resonance diffusion tensor imaging study of conductive aphasia after ischemic stroke

作　　者：陆强彬 张慧萍 陆梦茹 姜岐涛 LU Qiang-bin;ZHANG Hui-ping;LU Meng-ru;JIANG Qi-tao(Department of Neurology,Jiangyin Hospital Affiliated to Nantong University,Jiangyin 214400,Jiangsu,CHINA;Department of Imaging,Jiangyin Hospital Affiliated to Nantong University,Jiangyin 214400,Jiangsu,CHINA)

机构地区：[1]南通大学附属江阴医院神经内科,江苏江阴214400 [2]南通大学附属江阴医院影像科,江苏江阴214400

出　　处：《海南医学》2022年第1期74-78,共5页Hainan Medical Journal

基　　金：江苏省南通大学临床医学专项项目(编号:2019LY021)。

摘　　要：目的探讨缺血性卒中后传导性失语患者语言功能区的神经纤维损伤情况。方法选择2019年5月至2020年4月间于南通大学附属江阴医院住院的缺血性卒中后传导性失语患者20例为实验组,同期健康志愿者20例为对照组。采用3.0T磁共振成像系统,行头颅磁共振(MRI)和扩散张量成像(DTI)检查。由DTI后处理软件生成感兴趣区(ROI)各向异性指数(FA)、表观弥散系数(ADC)、容积比各向异性(VRA)及衰减指数(Exat)值,比较实验组患者病灶侧、病灶对侧以及实验组与对照组间上述各项指标的差异,分析缺血性卒中后传导性失语的DTI特征。结果实验组患者病灶均位于左侧大脑半球。实验组与对照组左侧ROI比较:(1)实验组患者左侧Broca区、Wernicke区及弓状纤维束FA值低于对照组,差异均有统计学意义(P<0.05);(2)实验组患者左侧弓状纤维束ADC值、VRA值低于对照组,差异均具有统计学意义(P<0.05),而两组患者左侧Broca区、Wernicke区ADC值、VRA值比较差异均无统计学意义(P>0.05);(3)实验组患者左侧Broca区及弓状纤维束Exat值高于对照组,差异具有统计学意义(P<0.05)。实验组患者左右侧ROI比较:(1)实验组患者左侧Broca区、Wernicke区及弓状纤维束FA值均低于右侧,差异具有统计学意义(P<0.05);(2)实验组左侧Broca区及弓状纤维束ADC值、VRA值低于右侧,差异具有统计学意义(P<0.05),而两侧Wernicke区ADC值、VRA值比较差异均无统计学意义(P>0.05);(3)实验组患者左侧Broca区、Wernicke区及弓状纤维束Exat值均高于右侧,差异均具有统计学意义(P<0.05)。纤维追踪技术研究显示,实验组患者病灶侧纤维束明显减少。结论缺血性卒中后传导性失语患者弓状纤维束及Broca区、Wernicke区神经纤维束均有不同程度受损,而DTI技术可用于诊断及评估此类患者语言功能区的破坏情况。Objective To investigate the nerve fiber injury in the speech area of patients with conduction aphasia after ischemic stroke by using diffusion tensor imaging(DTI). Methods Twenty patients with conduction aphasia after ischemic stroke were selected as the experimental group and 20 healthy volunteers as the control group. The 3.0 T MR system was used for the examination of cranial magnetic resonance imaging(MRI) and DTI. DTI software was used to generate fractional anisotropy(FA), apparent diffusion coefficient(ADC), volume ratio anisotropy(VRA), and exponential attenuation(Exat) values of region of interest(ROI). The difference between the focus side and the opposite side of the focus in the experimental group was compared, as well as the difference between the experimental group and the control group. And the DTI characteristics of conduction aphasia after ischemic stroke were analyzed. Results The lesions of the experimental group were all located in the left cerebral hemisphere. Comparison of left ROI between experimental group and control group showed that:(1) The FA values of Broca area, Wernicke area, and arcuate fiber bundle in the left side of the experimental group were significantly lower than those of the control group(P<0.05);(2) The ADC values and VRA values of arcuate fiber bundle in the left side of the experimental group were significantly lower than those of the control group(P<0.05), while the difference of ADC values and VRA values of Broca area and Wernicke area in the left side of the two groups was not statistically significant(P>0.05);(3) The Exat values of Broca area and arcuate fiber bundle in the left side of the experimental group were significantly lower than those of the control group(P<0.05). Comparison of the ROI between left and right sides in experimental group showed that:(1) The FA value of Broca area, Wernicke area, and arcuate fiber bundle on the left side was significantly lower than that of the right side(P<0.05);(2) The ADC value and VRA value of Broca area and arcuate fibe

关 键 词：缺血性卒中 传导性失语 磁共振扩散张量成像 感兴趣区 各向异性指数 表观弥散系数 容积比各向异性 衰减指数 

分 类 号：R743.3[医药卫生—神经病学与精神病学]