健康成人及脑肿瘤患者利手和非利手简单与复杂运动fMRI研究

MRI of Human Brain During Simple and Complex Movements of Dominant and Subdominant Hands in Normal Brain and Brain Tumors

目的:应用脑血氧水平依赖性功能MRI(BOLD-f MRI)研究健康成年人及脑肿瘤患者运动功能皮层定位并探讨其对脑肿瘤的临床应用价值。方法:10例健康志愿者和32例脑肿瘤患者(术前25例,术后7例)共42例受试者,行利手、非利手的单手握拳(简单运动)或单手对指(复杂运动)运动的脑BOLD-f MRI检查,分析脑肿瘤对运动皮层位置和功能的影响。结果:健康成人运动皮层主要位于对侧躯体感觉运动皮层(SMC),单或双侧辅助运动区(SMA)、运动前区(PMA)和双侧小脑半球。复杂运动或非利手运动时脑功能激活区范围和程度较简单运动或利手运动时增多。累及功能皮层的脑肿瘤患者,可见患侧部分脑功能区激活,但激活区移位、分布弥散。术后脑肿瘤患者功能皮层的位置基本恢复正常。结论:BOLD-f MRI是一种有效而无创的脑功能皮层定位方法,有利于脑肿瘤的精确定位诊断并指导临床治疗。

Objective：To investigate the location of functional activation areas of motor cortex with BOLD fMRI in normal brain and brain tumors,as well as to study the value of BOLD fMRI in the clinical application of patients with brain tumors. Methods： Forty two cases, including 10 healthy volunteers and 32 patients with brain tumor, experienced BOLD fM RI at a Marconi Eclipse 1. 5T MRI scanner. The functional images of brain motor cortex （activated by simple or complex finger movements of dominant and subdominant hands） were obtained. Results： The motor cortex of the normal brain were mainly located in contralateral somato-sensorial motor cortex （SMC）, unilateral or bilateral supplementary motor area （SMA）, pre-motor area （PMA） and bilateral cerebellum hemisphere. More cerebral motor areas could be activated by corn plex finger movements or subdominant hands than simple finger movements or dominant hands. For tumors involved functional area of brain cortex, the adjacent ipsilateral functional activation areas could be shrunk,displaced or diffusely distributed,but returned to normal after surgical operation. Conclusion： BOLD fMRI is an effective and non invasive approach in localizing motor cortex of brain and is valuable for the precise localization of brain tumor before surgery.