脑肿瘤引起的运动性失语的功能磁共振研究

The research of BOLD-fMRI in broca's aphasia resulting from brain tumor

目的探讨脑肿瘤引起的运动性失语脑内代偿情况。方法左侧Broca区肿瘤患者患者共13例,根据位置特点分为两组:一组为左侧Broca区脑肿瘤,未侵犯左侧额中回或额叶背外侧区;另一组为左侧Broca区脑肿瘤,侵犯左侧额中回或额叶背外侧区;对照其脑内代偿脑区的异同。正常健康志愿者20人,均为右利手。检查者均完成图片命名任务。AFNI软件处理实验数据。统计分析采用SPSS 12.0分析软件。同一感兴奋区(ROI)比较采用两样本t检验。结果①左侧Broca区脑肿瘤,未侵犯左侧额中回或额叶背外侧区:5例。激活脑区如下:左侧Broca周边脑区:BA46区(5/5);BA10区(3/5)。右侧Broca区激活;双侧额中回及双侧额叶背外侧区激活;双侧颞上回激活;左侧顶上小叶激活;双侧小脑半球,枕叶,双侧梭状回,左侧角回激活。统计学有阳性意义的脑区包括:左侧Broca周边脑区(BA46区,BA10区)及右侧Broca区;②病灶位于左侧Broca区,并累及左额背外侧区或额中回的灰质,激活脑区如下:右侧Broca区无或少量激活,无统计学意义;肿瘤周边脑区:BA46,BA47,BA10区出现不同程度的代偿激活;右侧额中回及右侧额叶背外侧激活;双侧颞上回激活;左侧顶上小叶激活;双侧小脑半球,枕叶激活,统计学有阳性意义的脑区主要为左侧Broca周边脑区:BA46,BA47,BA10区等。结论脑肿瘤所致运动性失语,脑内代偿方式因位置不同而有差异。

Objective To explore the functional compensation and reorganization of the Broca＇s aphasia resulting from the brain tumor. Methods There were 13 cases of brain tumors located in left Broca region. According to the different compensated regions with the location, patients were divided into two groups. In one group：tumors located in tbe left Bro- ca region, the left middle frontal lobe or the left frontal latcrodorsal areas didn＇t invaded. In the other group： tumors loca- ted in tbe left Broca region, the left middle frontal lobe or the left frontal laterodorsal areas invaded. 20 cases of normal healthy volunteers, right hand is predominant. The task of picture naming was be done. The same regions in two groups would be compared with the independent t tests. The experiment data were dealed with AFNI soft ware and analysed with SPSS 12.0. Results ① The lesions located in the left Broca region, the left middle frontal lobe or the left frontal lat- erodorsal areas didn＇t invaded： 5 cases. The activation regions were as following： the left BA46区（5/5）, BA10区（3/5）; the right Broca regions; Bilateral regions of MFG, FLDR, STG, LSPI., OL, FG, cerebellum. LSPL, LAG and so on. Among them the activation intention and volumes of the left BA46. BA10 and the right Broca region （BA44, 45 ） had sta- tistical significance. P〈0.05 ; ② The lesions located in tbe left Broca region, the left middle frontal lobe or the left frontal laterodorsal areas invaded= 8 cases the activated regions were： left BA46, BA47, BA10,RMFG, RFLDR, LSPL, bilateral STG, cerebellum and OL also be activated, null or little activated regions in the right Broca region. Among them the left BA46, BA47, BA10 had statistical significance. Conclusion The compensation modes of the Broca＇s aphasia were differ- enciated with different locations of brain tumors.