目的:观察正常志愿者及累及运动皮层颅内肿瘤病人的功能区分布,判断正常志愿者左、右手功能 区的激活是否对称;观察肿瘤及水肿邻近第一运动区(primary motor area,MI)但未累及MI 功能区的激活特征及 病变累及了MI 功能区的激活特征。 方法:20例正常志愿者及24例累及运动皮层的颅内肿瘤病人,通过拇指与 其余四指的对指运动激活功能区,采用血氧水平依赖(bloodoxygenationlevel dependent,BOLD)成像进行扫描,经 Functional 软件后处理获得相应的脑功能图。 结果:正常志愿者双侧功能区均明显激活,左、右手激活面积存在 不对称性;右利手者,右手动左侧半球激活程度强于右侧,而左利手者,左右大脑半球激活程度差别不明显;肿瘤 及水肿邻近MI 但未累及到MI 的病人,病变对皮层功能区的影响小,双侧功能区均明显激活,位置对称;而肿瘤 或水肿累及了MI 的病人,表现出患侧皮层功能区的移位、减小或重组。 结论:功能性磁共振(functional magnetic resonance imaging,fMRI)可直接观察功能区的分布、病灶与相邻功能区的关系及功能区的变化情况,对邻近及累 及运动皮层的病人肿瘤切除有十分重要的指导意义;术后应用同样的方法对比验证,可显示肿瘤切除术后功能 区残留,可为以后脑功能恢复提供客观评价。

Objective:Toexaminethefunctional areas of normal subjects andthepatients within鄄 tracerebral tumor,andtojudgewhether thebothfunctional areas of left andright handaresymmetrical innormal subjects,;Andtoobserveactivationfeatures of MI near totumor andedemabut without im鄄 plication,as well as that of MI where MI functional regions were implicatedby lesion. Methods:20 normal subjects and24patients withintracerebral tumor wereperformedwithBOLDtechnique. During eachscanseries,thepatients wererequestedtoperformrepetitivefinger-thumboppositionmovement in thesameperiodof active duration. All the scanning data were transformedto functional workstation anddealt withstatistical method. Finally,wecanget thebrainfunctional map. Results:For healthyvol鄄 unteers,functional signal was not symmetrical. Right -handers,right hand moving the degree of activationof the left hemisphere is stronger than the right,Left -handers,the left and the right hemisphereactivationdegreeof differenceis not obvious;For thepatients withmotor cortexlesion,the results of fMRI studies demonstratedthat the impact of lesiononmotor cortex. Involvedmotor cortexdisplayed,functional signal decreasedor motor cortexmigrated. Conclusions:fMRI candirectlyobserve thelocationof functional areas,therelationshipbetweenlesionareas andadjacent functional areas and changes of functional regions,whichshows animportant instructing significance for resecting tumors near to motor cortex or motor cortex implicated. Postoperatively,fMRI can display the residual functional areas andprovideobjectiveevidencetoevaluatetheconvalescenceof brainfunctions.

R445.2