摘要目的 探讨汉-英非熟练晚双语者的皮层语言区定位特点.方法 6例汉-英非熟练晚双语者,因语言区肿瘤需行唤醒手术,术前应用BOLD-fMRI执行单纯图片命名、图片动词联想及词语语义判断任务,术中应用直接皮层电刺激技术(DCS)作为语言功能定位的金标准定位汉、英语言区,对BOLD-fMRI的3种语言任务确定的激活区与术中DCS证实的语言区进行McNemer检验.结果 6例患者术中共刺激了71个点,发现语言区16个(22.5％).特定语言区3个,其中特定英语语言区2个,特定汉语语言区1个.BOLD-fMRI执行的3种语言任务与金标准DCS结果的比较,差异均有统计学意义(P ＜0.017).3种术前语言任务中动词联想任务的一致率最高为40.9％(95％ CI:30.2％ ～ 52.5％).结论 对于汉-英非熟练晚双语者,术中DCS可证实其优势半球内存在特定语言区,而BOLD-fMRI语言区定位不能替代.

abstractsObjective To discuss the distribution characteristics of language areas in ChineseEnglish non-fluent late bilinguals.Methods Six Chinese-English bilinguals with eloquent tumors underwent awake-surgeries.The activated areas of BOLD-fMRI were obtained as the patients performed pure naming,verb generation,and abstract/concrete judgment tasks.Direct cortical stimulation (DCS) as the golden standard of language mapping were performed during awake-surgeries on the exposed cortical areas.BOLDfMRI results of 3 language tasks were compared with DCS results.The statistical method was McNemer.Results Sixteen positive sites (22.5％) were comfirmed out of 71 stimulations.There were 3 specific language sites,in which 2 sites were specific English sites and 1 site was specific Chinese site.When activated areas of BOLD-fMRI were compared with the DCS results,verb generation task had the highest concordance rate 40.9％ (95％ CI:30.2％-52.5％).There were significant differences between the results of BOLD-fMRI and DCS of all 3 bilingual tasks (P ＜ 0.017).Conclusions There are specific language areas in Chinese-English non-fluent late bilinguals.The BOLD-fMRI language mapping could not substitute DCS in the context of mapping language areas in bilinguals.