《中国康复理论与实践》

《中国康复理论与实践》 ›› 2011, Vol. 17 ›› Issue (8): 705-708.

• 论文 • 上一篇    下一篇

应用影像学方法探讨类似运动性和感觉性的传导性失语发病机制

张红霞1a，赖宗力2，陈红燕1b，周筠1c，张玉梅1c   

  1. 1.首都医科大学附属北京天坛医院，a.高压氧科；b.医学影像学中心；c.神经内科，北京市 100050；2.北京应用物理与计算数学研究所，北京市 100088。
  • 收稿日期:2011-06-03 修回日期:1900-01-01 出版日期:2011-08-25 发布日期:2011-08-25
  • 通讯作者: 张玉梅

Pathogenesis Investigation of Broca-like and Wernicke-like Conduction Aphasia Using Image Methods

ZHANG Hong-xia, LAI Zong-li, CHEN Hong-yan, et al.   

  1. Department of Hyperbaric Oxygenation, Beijing Tiantan Hospital, Affiliated to Capital Medical University,Beijing 100050, China
  • Received:2011-06-03 Revised:1900-01-01 Published:2011-08-25 Online:2011-08-25

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摘要： 目的探讨临床上类似运动性和感觉性的传导性失语发病机制。方法分别选择7 例类似运动性失语和7 例感觉性失语症的传导性失语患者以及10 例健康志愿者，采用扩散张量成像分析研究Broca 区、Wernicke 区及弓状纤维束，并测量三者的各向异性(FA)值，分别比较健康志愿者与传导性失语患者双侧大脑半球的FA 值；采用扩散张量成像纤维追踪的方式，比较Broca区、Wernicke 区的纤维结构。结果在健康志愿者中，左侧大脑半球各项FA值大于右侧(P<0.05)；在类似运动性失语症的传导性失语患者中，左侧Broca 区以及弓状纤维束前部的FA 值小于右侧镜像区(P<0.05)；在类似感觉性失语的传导性失语患者中，左侧Wernicke 区以及弓状纤维后部的FA值小于右侧镜像区(P<0.05)，Broca 区的FA值与正常健康志愿者相似。结论除弓状纤维束受损外，皮层的病变同样可以引起传导性失语。如果病变部位靠近Broca 区且弓状纤维束的前部受损，则临床症状类似于运动性失语症；靠近Wernicke 区且弓状纤维束的后部受损，则类似于感觉性失语症。

关键词: 扩散张量成像, 扩散张量成像纤维追踪, 类似运动性失语症的传导性失语, 类似感觉性失语症的传导性失语

Abstract: To investigate the pathogenesis of Broca-like and Wernicke-like conduction aphasia. Methods 7 cases with Broca-like aphasia (Group A), 7 cases with Wernicke-like aphasia (Group B) and 10 healthy volunteers (Group C) participated in the study. Broca'sarea, Wernicke's area, and the arcuate fasciculus were analyzed by diffusion tensor imaging, and their fractional anisotropy (FA) weremeasured and compared; The fiber construction of Broca's and Wernicke's areas were also compared by diffusion tensor imaging-fibre tractography.Results In Group C, All of the FA was higher in the left hemisphere than in the right hemisphere (P<0.05); In Group A, the FA ofthe Broca's area and anterior segment of the arcuate fasciculus were less in the left than in the right hemisphere (P<0.05)； In Group B, theFA of the Wernicke's area and posterior segment of the arcuate fasciculus were less in the left than in the right (P<0.05). Conclusion Conductionaphasia results not only from arcuate fasciculus destruction, but also from disruption of the associated cortical area. A lesion involvingBroca's area and the anterior segments of the arcuate fasciculus would lead to Broca-like conduction aphasia, whereas a lesion involvedWernicke's area and posterior segments of the arcuate fasciculus would lead to Wernicke-like conduction aphasia.

Key words: diffusion tensor imaging, diffusion tensor imaging-fibre tractography, Broca-like conduction aphasia, Wernicke-like conduction aphasia