低级别胶质瘤术前语言功能区的fMRI研究

Preoperative fMRI for identifying language cortices in patients with low grade gliomas

目的：采用恻研究低级胶质瘤语言功能区分布及偏侧性特点。方法：对15例左侧额、颞叶经病理证实的低级别胶质瘤（WHOI～Ⅱ级）患者进行例术前图片命名刺激任务的删研究，另选择10例健康人作为对照组。哪数据处理采用工作站自带软件显示激活脑区并计算偏侧性指数（LI）。结果：对照组激活脑区：左侧为主的双侧额下回、额中回、左侧颞上回、以左侧为主的双侧顶上小叶、前运动区、双侧枕叶、双侧小脑。胶质瘤组的激活脑区：双侧额下回、额中回、左侧为主的双侧颞上回、双侧顶上小叶、双侧枕叶、双侧小脑等。对照组中8例表现为左侧大脑半球优势，2例为双侧大脑半球优势，LI值为84．61％。患者组中5例表现为左侧大脑半球优势，3例为右侧大脑半球优势，7例表现为双侧大脑半球优势，LI为60．15％。结论：fMRI能在术前可靠显示低级别胶质瘤周围语言功能区的分布及语言偏侧性，对术前计划制定有重要意义。

Objectlve：To assess the feasibility of presurgical fMRI for the location and lateralization of language function in patients with low grade glioma. Methods： Fifeen patients with low grade gliomas confirmed by pathology involving left frontal and temporal lobe performed preoperative fMRI studies with picture naming tasks. Ten healthy volunteers were enrolled as control subjects. The related workstation was used to postprocess fMRI data. The activated language related areas were recorded and activated volume was calculated, the lateral index（LI） was caleulated to evaluate the asymmetry of hemisphere. Results： The activation areas including bilateral inferior frontal gyms and middle frontal gyms （left dominant）, left superior temporal gyrus, bilateral superior parietal lobule （left dominant） and premotor area in control subjects. Bilateral inferior frontal gyms, bilateral middle frontal gyms, bilateral superior temporal gyras（left dominant） and bilateral parietal lobale were the most common activation areas in patients. In addition, bilateral occipital lobes and cerebellum were common seen in both groups. Eight with left hemisphere dominant and two with bilateral hemisphere dominant and the LI was 84.61% in control subjects. However, five patients showed left hemisphere dominant and ten with right or bilateral hemisphere dominant and the lateral index was 60.15% in patients. Conclusion： fMRI is a reliable technique in identifying the location and lateralization of language in patients with low grade glioma and helpful in making preoperative planning.