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目的探讨功能性磁共振成像(functional magnetic resonance imaging,fMRI)诊断脑卒中患者记忆能力的价值。方法 2013-08/2016-02月选择在作者医院诊治的脑卒中患者72例作为脑卒中组,同期选择在作者医院进行体检的健康人72例作为对照组,2组都选择威斯康星卡片分类测验(Wisconsin card sorting test,WCST)表格进行工作记忆能力测定,同时进行fMRI诊断与相关性分析。结果脑卒中组的任务执行正确率与正确反应时间分别为(0.71±0.08)%和(734.22±38.13)s,都明显低于对照组的(0.83±0.10)%和(598.22±46.14)s,组间比较差异具有统计学意义(P<0.05)。脑卒中组的左右侧额叶、扣带回前部、胼胝体膝部的各向异性分数(fractional anisotropy,FA)值明显低于对照组,对比差异有统计学意义(P<0.05)。脑卒中组中,直线性分析显示左右侧额叶的FA值与任务执行正确率、正确反应时间、扣带回前部中呈现负相关性(P<0.05),在胼胝体膝部中无相关性(P>0.05)。结论脑卒中患者的工作记忆能力有明显障碍,fMRI显示额叶白质纤维的损害是脑卒中患者的工作记忆能力的重要解剖学基础之一,有很好的诊断应用价值。
Objective To investigate the value of functional magnetic resonance imaging (fMRI) in the diagnosis of memory in stroke patients. Methods Seventy - two stroke patients who were diagnosed and treated in the author hospital from January 2013 to February 2016 were selected as the stroke group. In the same period, 72 healthy people were selected as the control group in the author hospital. Two groups were selected the Wisconsin Card Sorting Test Wisconsin card sorting test, WCST) table for working memory capacity, while fMRI diagnosis and correlation analysis. Results The correct rate of task execution and correct response time in stroke group were (0.71 ± 0.08)% and (734.22 ± 38.13) s, respectively, which were significantly lower than those in control group (0.83 ± 0.10) and (598.22 ± 46.14) s, The difference between the groups was statistically significant (P <0.05). The fractional anisotropy (FA) of the left and right frontal lobe, cingulate gyrus and knee of the corpus callosum in the stroke group were significantly lower than those in the control group (P <0.05). In the stroke group, the linear analysis showed that the FA values of left and right frontal lobes were negatively correlated with the accuracy of task execution, correct response time, and anterior cingulate cortex (P <0.05), but not in the corpus callosum (P> 0.05). Conclusions The working memory ability of patients with stroke is obviously obstructed. The fMRI shows that the damage of frontal lobe white matter fibers is one of the important anatomic bases of working memory in patients with stroke, and it has good diagnostic value.