摘要
目的:联合应用血氧依赖功能磁共振成像和弥散张量成像技术纵向观察视觉通路病变的皮质功能和白质纤维结构的动态变化,探讨病变后恢复期脑功能和结构重组的特点。方法:病变组患者为2006-01/09解放军南京军区福州总医院收治,因视觉通路病变致单侧或双侧视觉障碍患者8例,采用美国GE公司Signa Excite HD 1.5T双梯度16通道磁共振成像系统,在病变早期和恢复期分别进行血氧依赖功能磁共振成像和弥散张量成像检查,对比治疗前后双眼刺激下脑激活区的体积以及视放射解剖结构、局部各向异性值,并与对照组12名正常被试比较。结果:20例受试者均完成测试进入结果分析。①血氧依赖功能磁共振成像结果:正常被试采用黑白棋盘格刺激明显激活双侧枕叶距状回,平均激活皮质体素数为(9.12±2.47)万;病变组患者双眼刺激视皮质激活体积较对照组比较明显减少(P<0.05),治疗后复查,刺激的皮质激活像素数增多,激活区扩大。②弥散张量成像三维纤维束重建:对照组双侧视放射均能追踪至皮质下,12例被试视放射平均部分各项异性值为0.39±0.13。病变组中4例视觉通路病变患者视放射显示完整,与对照组间比较无明显差异,治疗前后纵向观察亦无显著变化;4例枕叶视中枢病变患者患侧视放射纤维部分中断、纤细,并可见移位,部分各项异性值均明显下降,治疗后视放射纤维束有一定程度恢复,部分各项异性值增加。结论:血氧水平依赖功能磁共振成像联合弥散张量成像从皮质功能和纤维解剖方面诠释了病变的发展及康复过程,可帮助了解视觉通路病变后皮质功能区的重组。
AIM： To observe the dynamic change of cortex function and substantia alba fibrous structure and features of brain function and structure reorganization revolved with visual pathway diseases longitudinally combined of blood oxygen level dependent functional magnetic resonance imaging （BOLD-fMRI） and diffusion tensor imaging .（DTI）.
METHODS： Totally 8 patients with unilateral or bilateral visual defect due to visual pathway diseases, who ware treated at Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from January to September 2006, ware enrolled as lesion group. Both fMRI and DTI ware performed at Signa Excite HD 1.5T system with dual gradients and 16 channels at eady and mid-term recovery. The activation volume, optic radiations structure and fractional anisotropy ware studied under bilateral eye irritation before and after treatment. These symptoms of the 8 patients ware compared with the 12 control subjects.
RESULTS： Totally 20 subjects ware involved in the result analysis. ①BOLD-fMRI： The 12 control subjects showed obviously activated in optic cortex with visual stimuli. The average activation volume was （9.12 ±2.47）×10^5. Compared with the control group, the patients＇ activation volume was reduced obviously in the lesion group （P 〈 0.05）. After therapy, the patients＇ activation increased. ②DTI and fiber tracing showed perfectly optic radiation in the control group. The average fractional anisotropy was （0.39±0.13）. Perfectly optic radiation was found in 4 cases in the lesion group and no significant difference was seen compared with the control group and no significant difference was also seen in longitudinal observation before and after treatment. Partial optic radial fiber broke off, became thin and moved, and fractional anisotropy significantly decreased, whereas after treatment the optic radial fiber situation was improved to some extent and fractional anisotropy increased in 4 occipital optical center injury patients.
CONCLUSION： The
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第31期6218-6223,共6页
Journal of Clinical Rehabilitative Tissue Engineering Research
