摘要
目的:通过功能磁共振揭示的语言功能区血流量及代谢的变化,探讨失语症可能的发病机制,为语言康复训练提供理论指导。方法:对10例有明确失语症临床表现,CT或M RI证实为脑卒中的患者进行北京医科大学第一医院的汉语失语症成套测验中的利手评定标准进行利手评定、西部失语评定标准判断失语症类型,采用Frenchy构音障碍评定标准进行构音障碍的评定,采用普通磁共振确定病变部位,并用功能磁共振对病变可能波及的语言功能区进行磁共振波谱分析及磁共振灌注成像分析,并与对侧相应区域进行对比。结果:10例脑卒中患者利手评定,结果有8例为右利手,2例为左利手,经西部失语评定有5例为运动性失语,4例为感觉性失语,1例为传导性失语,M RI提示病变部位均为左侧大脑半球;M R S均显示语言功能区的N-已酰天门冬氨酸、胆碱、肌酸的代谢较对侧相应区域降低;PW I显示受累语言功能区的局部脑血容量、局部脑血流量较对侧减低,对比剂平均通过时间、达峰时间较对侧延长。结论:失语症患者语言功能区均呈低灌注、低代谢表现,这可能为失语症的发病机制,在制订语言康复计划时,可适当提高语言功能区的灌注与代谢,促进失语症的康复。
Objective:To approach aphasia pathogenesy by observing cerebral blood flow and metabolism changes of language areas through functional magnetic resomance.Method: Ten cases were studied who suffered from stroke and had aphasia characterstics with the handedness of aphasia battery of China, the western aphasia battery and Frenchy dysarthria battery. Not only CT and MRI were used to decide the pathological site but also the language areas was analysed by magnetic resonance spectroscopy and perfusion weighted imaging,The results compared with that of the same position in the opposite. Result:There were 8 right-handedness and 2 left-handedness in the 10 stroke patients,Aphasia types were 5 motor aphasia cases?4 sensory aphasia cases and 1 conductive aphasia case. It′s suggested by MRI that disease sites were at left hemisphere;MRS showed that the language areas's aminosaccinic?choline and creatine were reduced than that of the same site of the right hemisphere;PWI discovered that the damaged language areas's regional cerebral blood volume and regional cerebral blood flow were decreased than that of the right hemisphere, mean transit time and time to peak were increased than that of the oppsite.Conclusion:Language areas of aphasia patients are hypoperfusion and hypometabolism,which may be the mechanisms of aphasia.
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2005年第4期267-269,282,i001,共5页
Chinese Journal of Rehabilitation Medicine
