摘要目的 通过术前功能磁共振成像(fMRI)技术探讨位于优势侧半球脑动静脉畸形(AVM)患者主要汉语功能区的偏侧化情况.方法 病变组为2017年12月至2018年6月在北京天坛医院诊断为AVM且位于优势侧半球的患者,共14例;对照组为母语为汉语的健康志愿者,共9例.对2组对象分别进行包括同义字判断、单字朗读和听力理解三种汉语任务下的fMRI扫描.采用SPM12软件进行数据分析和脑功能区定位,记录各激活脑区的像素值并计算偏侧化指数(LI)以确定优势侧半球.结果 两组对象的性别、年龄均差异无统计学意义(P＞0.05).两组受试者经WAB语言量表评估均无语言功能障碍.行3种语言任务时,对照组共有0/27次(0％)主要语言区出现右侧半球优势,而病变组共有8/42次(19％)主要语言区出现右侧半球优势,两者差异有统计学意义(x2=5.73,P=0.019).结论 脑AVM患者中不同的汉语语言任务其语言中枢优势侧半球可能并不相同;相对于正常对照,位于优势侧半球的脑AVM患者,其主要语言功能区更容易发生非优势侧半球的功能重塑.

abstractsObjective To investigate the functional lateralization of major Chinese language cortex in patients with cerebral arteriovenous malformation (AVM) in dominant hemispheric via functional magnetic resonance imaging (fMRI).Methods Nine right-handed normal volunteers and fourteen patients with cerebral AVM in dominant hemisphere diagnosed in Beijing Tiantan Hospital between December 2017 and June 2018 were included.Three language tasks (semantic judgment,word reading,and listening comprehension) were applied to activate language areas.Lateralization index (LI) was used to show the dominant hemisphere.Results In the control group,right-sided lateralization of BOLD signal activations was observed in 0/27 (0％) of the language tasks.While in the AVM patients,right-sided lateralization of BOLD signal activations was observed in 8/42 (19％) language tasks.The difference was statistically significant (x2=5.73,P=0.019).Conclusions The dominant hemisphere of different language tasks may be different in patients with cerebral lesions.Compared with normal controls,patients with cerebral AVM in dominant hemispheric are more likely to have right-sided lateralization of language cortex.