本文選題：脊髓型頸椎病 + 功能磁共振　； 參考：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:應(yīng)用血氧水平依賴功能磁共振成像技術(shù)(BOLD-f MRI)研究脊髓型頸椎病患者行頸椎管減壓手術(shù)前和手術(shù)后進(jìn)行右手敲指運(yùn)動時腦皮質(zhì)功能性激活的情況,進(jìn)而探討頸椎管減壓手術(shù)后腦皮質(zhì)重構(gòu)的變化對神經(jīng)功能恢復(fù)的影響。方法:依據(jù)診療常規(guī)對試驗組19例患者行頸椎管減壓手術(shù)。于術(shù)前和術(shù)后12個月對試驗組進(jìn)行改良日本骨科協(xié)會(m JOA)評分評估,并同時行腦功能和常規(guī)磁共振掃描。19例對照組也進(jìn)行相同范式的腦功能和常規(guī)磁共振。所有對象的腦功能磁共振動作任務(wù)為右手敲指運(yùn)動。試驗組的數(shù)據(jù)和圖像按照采集時間分為術(shù)前組和術(shù)后組,并進(jìn)行腦功能數(shù)據(jù)分析。結(jié)果:術(shù)后組m JOA評分均顯著提高(P0.001)。術(shù)前組激活體積(VOA)顯著高于對照組(P0.05)。術(shù)后組VOA降低,但仍顯著高于對照組(P0.05)。術(shù)前組僅在左側(cè)中央前回(Pr CG)可探及激活信號,術(shù)后組在左側(cè)中央后回(Po CG)、前運(yùn)動(PMA)和輔助運(yùn)動區(qū)(SMA)可探及激活信號,右側(cè)部分皮質(zhì)也可探及少量激活信號。術(shù)后組m JOA上肢運(yùn)動和感覺評分的提高程度與左側(cè)運(yùn)動和感覺皮質(zhì)VOA的降低程度具有顯著的相關(guān)性(P0.05)。結(jié)論:脊髓型頸椎病患者腦皮質(zhì)區(qū)可發(fā)生代償重構(gòu),引起感覺和運(yùn)動功能激活區(qū)域的擴(kuò)大和移位。頸椎管減壓術(shù)后的腦皮質(zhì)重構(gòu)變化與神經(jīng)功能的恢復(fù)有關(guān)。手術(shù)治療可能促進(jìn)了產(chǎn)生代償性作用的皮質(zhì)重構(gòu)。
[Abstract]:Objective: to study the activation of cortical function in patients with cervical Spondylotic myelopathy (CSM) before and after decompression of cervical spinal canal before and after right hand knockout exercise using the blood oxygen level dependent functional magnetic resonance imaging technique.The effect of cortical remodeling on the recovery of neural function after cervical decompression was investigated.Methods: 19 patients in the experimental group were treated with cervical canal decompression according to the routine diagnosis and treatment.The modified Japanese Orthopedic Association (JOAA) score was evaluated before and 12 months after operation in the trial group. Brain function and conventional magnetic resonance imaging (MRI) were also performed in 19 cases of the control group.All subjects had functional magnetic resonance imaging (fMRI) action tasks for right-hand finger tapping.The data and images of the experimental group were divided into preoperative group and postoperative group according to collecting time, and brain function data were analyzed.Results: the m JOA score of postoperative group increased significantly (P 0. 001).The activation volume of VOAin the preoperative group was significantly higher than that of the control group (P 0.05).The VOA of the postoperative group was lower than that of the control group (P 0.05).In the precentral gyrus, the activated signal could be detected only in the left precentral gyrus. In the postoperation group, the signal could be detected and activated only in the left posterior central gyrus (PMA) and the auxiliary motor area (SMAs), and a small amount of activation signals could also be detected in the right cortex.There was a significant correlation between the improvement of m JOA upper limb motor and sensory score and the decrease of VOA in the left motor and sensory cortex after operation (P 0.05).Conclusion: compensatory remodeling may occur in the cortical area of cervical Spondylotic myelopathy patients, resulting in the expansion and displacement of sensory and motor activation areas.The changes of cortical remodeling after cervical decompression are related to the recovery of neural function.Surgical treatment may promote compensatory cortical remodeling.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R445.2;R687.3

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本文編號：1750834