目的：观察语言功能区相关的脑肿瘤患者脑语言功能区定位，评价脑肿瘤患者脑语言功能区定位与肿瘤之间的空间关系，评价语言功能区偏侧化优势现象。方法：19例左侧额叶语言相关脑区脑肿瘤患者，行汉语语义、语法句子正确性判断任务，并同时采集fMRI数据。应用SPM8软件行预处理后，对符合要求的受试者数据进行分析，得出脑平均激活图，并计算偏侧化指数（LI）。结果：对19例脑肿瘤患者的数据处理后，语义、语法判断任务主要激活双侧额中回、双侧额上回、右侧额内侧回、双侧颞上回、左侧颞下回、左侧颞中回、双侧缘上回等脑功能区，发现左额叶和病灶周围的脑功能区激活明显。另外右半球相应镜像脑功能区域亦可见激活，但激活区不明显。计算LI值，LI>0，提示为左侧优势。结论：病灶的占位效应以及生长方式导致脑组织结构重组，使得病灶周围无损害脑区及健侧镜像脑区代偿了部分语言功能。BOLD-fMRI可为语言区的空间定位研究提供可靠的方法，可有效指导临床手术切除肿瘤病灶。
Abstract
Objective: To observe the location and the language lateralization of language functional areas in patients with brain tumors. To evaluate the relationship between the location of the lesion and the language lateralization of functional language areas, and determine the Chinese language hemisphere. Finally analyzed the cause of this phenomenon. Methods: Nineteen patients were enrolled the study, to perform the semantic and syntactic paradigm. Functional data was collected when performed the language tasks and analyzed by SPM8. Using specify 2nd level(single sample t-test) for group analysis. Then locating the functional language areas and determining the Chinese language hemisphere. Results: In the case of 19 patients with brain tumors, bilateral medial frontal gyrus, bilateral superior frontal gyrus, right medial frontal gyrus, bilateral superior temporal gyrus, left inferior temporal gyrus, left middle temporal gyrus, the bilateral supramarginal gyrus etc were significantly activated. The LI was more than 0. The dominant hemisphere in patients with brain tumor was in left side. Conclusion: The mass effect due to growth of the brain tumors led to the restructuring of the brain tissue. And the normal brain regions around the lesion and the right hemisphere corresponding mirror brain areas may compensate for the part of the language function. BOLD-fMRI provides a reliable method for evaluating the relationship between the location of the lesion and the functional language areas. It is helpful for perfectly excision of the lesion in the surgery.
关键词
脑肿瘤 /
磁共振成像
Key words
Brain neoplasms /
Magnetic resonance imaging
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参考文献
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基金
本课题为国家自然科学基金资助（8171654）
