【摘要】 目的探讨Bold-fMRI在功能区低级别胶质瘤中的应用及语言功能区的可塑性。方法对15例低级别胶质瘤及14例正常人行fMRI检查并作体素分析。病人在功能影像、术中电刺激指导下进行手术,结合语言测评、影像评估及Karnofsky功能状态评分(KPS)等进行随访。结果病人较正常人半球激活指数(HAI)低,提示语言功能区重塑。肿瘤全切除11例,近全切除4例。术后短期内有不同程度失语7例,术后3个月均得以恢复。术后KPS评分较术前提高。结论Broca区低级别胶质瘤病人术前、术后语言功能区具有可塑性;应用术前功能影像及术中电刺激指导手术治疗,可提高肿瘤的切除程度,同时亦可保护语言功能。更多还原

【Abstract】 Objective To investigate the significance of blood oxygenation level dependent-fMRI (Bold-fMRI) in low-grade gliomas within Broca area,focusing on plasticity of language function area. Methods Fifteen patients and 14 healthy subjects were enrolled in this experiment and received conventional MRI and fMRI language evaluation with a statistical analysis. The resections were guided by fMRI and intraoperative electrical stimulation for functional mapping. The patients were followed up by postoperative speech evaluation,fMRI and quality-of-life assessment. Results The lower hemispheric activation index in the patients than healthy subjects suggested plasticity of language function. Total and subtotal tumor resections were achieved in 11 and 4 patients,respectively. Postoperatively,7 patients had aphasia to varying extents in short term,but recovered to normal 3 months later. All patients recovered and returned to a normal socioprofessional life (KPS score of 90-100). Conclusion Language function area has the plasticity in patients with low-grade glioma. Combination of fMRI and language mapping techniques can improve resection of tumor and protect the language function of the patient.更多还原