脑卒中偏瘫患者康复前后手主动运动与被动运动功能磁共振影像分析

Identification of Active and Passive Hands Motor Cortex Area with Functional MR Imaging in Hemipegic Patients after Stroke

目的探讨脑卒中偏瘫患者皮质运动区功能变化及康复后脑功能重组。方法对23例脑卒中偏瘫患者进行双侧手指的主动运动和被动运动脑功能磁共振成像(fMR I)检查。在患者接受系统康复训练后重复检查。影像学结果与患者的临床症状进行对比评价。结果所有患者的常规MR I表现为运动功能区脑梗死或相应皮质脊髓束通路脑梗死;在脑功能成像检查中,健侧手指运动功能区显示基本正常;除2例患侧肢体肌力0级而未能表现功能区外,其余患者在对应的皮质运动功能区显示缩小或伴移位,有13例患者的患侧手指在被动运动时运动功能区能显示。7例患者在接受系统的康复治疗后,患侧肢体手指运动功能区的显示与其临床症状的好转一致。结论fMR I研究可为手指主动运动和被动运动的皮层功能区定位提供影像学资料,为临床进行康复和预后评估提供帮助。

Objective To identify the finding of functional MRI （fMRI） during active and passive fingers moving in hemipegic patients after stroke. Methods 23 stroke patients with hemipegia were asked to actively moving their fingers and then passively moving with others＇ help. MSEPI technique was performed with planar parallel AC-PC. During each scan series, theywere asked to perform repetitive fingerthumb opposition movement in the same period of active and rest. All the scanning data was transferred to a workstation and dealt with statistical method. Some patients examined fMRI again after rehabilitation. Results fMRI showed normal in the healthy side, with the decrease or displacement in the affected side of motor cortex area. Motor cortex area in the affected side would be recovered after rehabilitation. Conclusion fMRI can be used to evaluate the difference between active and passive moving motor cortex, and help to judge the prognosis of the patients with motor functional disorder.