血氧水平依赖功能磁共振成像在累及运动区脑肿瘤中的应用

Application of BOLD-fMRI in evaluation of brain tumors involving the motor system

目的:功能磁共振成像对脑肿瘤术前评估具有重要意义,探讨血氧水平依赖功能磁共振成像(Bold-fMRI)在累及运动通路脑肿瘤中的应用价值。方法:对16例累及皮层运动区的脑肿瘤患者行fMRI检查,另以10例健康者作为对照,2例患者术后复查,fMRI采用双侧交替进行的大拇指对掌运动作为任务刺激。所有数据进行离线后处理,fMRI图像使用基于MATLAB平台下运行的SPM99软件进行处理,观察运动皮层区激活情况。结果:每个患者的健、患侧主运动区(M1)、辅助运动区(SMA)均激活,其中12例患侧M1区信号低于健侧,3例患侧M1区信号高于健侧,1例健侧与患侧M1区信号无明显差别,11例患侧M1区信号移位,8例患者患侧SMA区及健侧M1区的激活程度较健康人增强;2例患者复查显示患侧M1皮层激活范围较术前变小。结论:应用fMRI能显示肿瘤、皮层运动功能区之间的关系,对邻近脑运动功能区脑肿瘤患者术前评估具有重要意义。

Objective：fMRI play an important role in the preoperative comprehensive evaluation in the patients with brain tumors adjacent to motion function area, to evaluate the value of blood oxygen level dependent-functional magnetic resonance imaging（BOLD-fMRI or fMRI） in the evaluation of brain tumors involving the motor system. Methods：Sixteen patients with brain tumors that were located close to or in the precentral gyrus and ten normal subjects were investigated; two postoperative patients were also included, fMRI was performed by a fist clenching paradigm. For imaging processing, fMRI analysis was performed with SPM99.Results：Primary motor aera （MI） and supplementary motor aera （SMA） were activated for every patient, M1 signal at the injured side was lower than that at the uninjured side in twelve patients; in three patients, M1 signal at the injured side was higher than at the uninjured side; in another patient, there was not significant difference between the M1 signals at both sides. The position of M1 signal at the injured side changed in eleven patients. In eight patients, the signal intensity of SMA at the injured side and signal intensity of M1 at the uninjured side was reinforced than ones in healthy volunteers. Postoperative imaing follow-up showed reduced activation of M1 in comparison of preoperative data in two patients. Conduslon：fMRI is helpful for identifying the relationship between the brain tumors and motor cortex, playing an important role in the preoperative evaluation in the patients with brain tumors adjacent to motion function area.