| Objective:Aphasia is an acquired language disorder with impaired acquired language ability caused by brain lesions.At resent,there are many causes of aphasia,including intracranial tumors,cerebral hemorrhage,cerebral infarction,craniocerebral trauma,craniocerebral inflammation,and cerebrovascular disease.Impaired language function will lead to a serious reduction in the quality of life,bring huge pain and psychological burden to patients,and bring heavy pressure on the family and society.With the development of science and technology,many scientific and technological inspection methods have emerged at the historic moment,such as EEG,cortical evoked potentials,and magnetoencephalograms,which have greatly promoted human understanding of the human brain language system.Diffusion Tensor Imaging(DTI)is currently widely used in imaging,neuroscience,psychiatry,cognitive science,and psychological medicine.This technology makes it possible for in-vivo imaging of human brain white matter fiber bundles.In this study,DTI technology was used to study the changes of white matter fiber bundles in the language functional area of patients who have intracranial tumors with motor aphasia(Broca aphasia)and the value of DTI in surgical guidance and clinical treatment.Methods:In this study,we collected data from 18 hospitalized patients with intracranial tumors diagnosed as HGG from December 2017 to August 2019,and 15 healthy volunteers.All subjects were right-handed who tested by the Edinburgh hand scale.A 3.0T Siemens magnetic resonance machine was used for routine craniocerebral MRI and DTI of all subjects to obtain head rest DTI data.Aphasia patients should undergo MRI examinations within one week before and three months after the operation,and completed a Western aphasia test before each examination.DSI-studio software was used to perform head motion correction and eddy current correction on the resting DTI image.Firstly,the diffusion tensor tractography(DTT)tracking technology was used to renconstruct the arcuate fasciculus,then AF's direction,distribution and the anatomical relationship with intracranial tumors were observed.Secondly,the fractional anisotropy(FA)value and average diffusion coefficient(ADC)value of Broca area and its opposite mirrored area,and the white matter fiber bundles around tumors and its opposite mirrored area in both Case control group and aphasia group.Data analysis was performed by SPSS Statistics 20 software.The FA value and ADC value of the Broca area on the left side and the opposite mirrored area of the control group were tested by paired sample t test,the FA value and ADC value of the left Broca area and the opposite mirrored area of the aphasia group were subjected to paired sample t test,the FA value and ADC value of Broca area on the left of the aphasia group before operation compared with the control group by two-sample independence t test,the FA value and ADC value of the white matter fiber bundles around tumors compared with its opposite mirrored area by paired sample t test,the postoperative FA value and ADC value of the white fiber bundles around tumors three months after operation compared with its preoperative by two-sample independence t test.The difference was considered statistically significant when P <0.05.Results:1.The 18 patients with motor aphasia who performed in this study were all right-handed,but only 15 patients finally completed the image acquisition.2.The FA value in the Broca area on the left side of the aphasia group was 0.367 ± 0.135,and the ADC value was 0.857 ± 0.313.The FA value in the left Broca area of the control group was 0.496 ± 0.033,and the ADC value was 0.826 ± 0.083.Compared with the control group,the FA value was visible.The difference was statistically significant(t =-4.925,P = 0.036),and the ADC value was not statistically different(t =-2.469,P = 0.351).The aphasia group befor surgery,the FA value of the left white matter fiber bundle around the tumor was 0.353 ± 0.136,the ADC value was 1.117 ± 0.156,the FA value of the healthy side mirror area was 0.574 ± 0.132,and the ADC value was 0.862± 0.122.Compared with the mirror area,the FA value Significantly decreased,ADC value increased significantly,and the difference was statistically significant(t =-5.695,6.276,P = 0.001,0.003).The FA value of the white matter fiber bundle around the tumor in the aphasia group after surgery was 0.366 ± 0.169,and the ADC value was 1.129 ± 0.081,which was not statistically different from that before surgery(t = 0.165,0.173,P = 0.874,0.868).3.The left side of the control group is thicker than the right side.Before the aphasia group,the left fiber bundle showed different degrees of infiltration and pushing,damage and fracture,and the integrity of the local anatomy was significantly affected.Conclusion:In this study,DTI and DTT techniques were used to study right-handed high-grade glioma patients with Broca aphasia,and the following conclusions were reached:1.In high-grade gliomas,the FA value of the white matter area around the tumor decreases,and the ADC value increases,providing a basis for confirming the extent of tumor destruction.2.Broca aphasia can be caused by local cortical damage or by damage to its fibrous connection pathways.3.DTI is currently the only non-invasive,in-vivo,visualized imaging technique that shows the anatomical relationship between tumors and surrounding white matter fiber bundles.The surgical plan provides important guidance. |
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