目的 运用功能磁共振成像对脑卒中后及康复过程进行观察，分析相应脑内运动功能区激活的变化情况，对不同运动模式下皮质功能再塑的表现进行探讨。方法 选取本院2012年7月～2013年7月收治的30例脑卒中患者，在发病后一周开始连续两个月的康复治疗。运用Brunnstrom分级、Caroll上肢功能量表对患者康复前和康复后1、2个月的手功能进行评价。使用血氧水平依赖法观察康复病人经镜像治疗后血氧水平的变化。采用GE MR/iHSpeed 1.5磁共振扫描机进行成像功能激发检查。患者用病手执行随意运动、简单运动等，获得脑功能激发图像后，对脑内相关功能区的激活情况进行观察。结果 患者康复前Brunnstrom分级均为III级，Caroll平均分为(3.5±1.3)分；康复治疗后1个月Brunnstrom分级为III级或IV级，Caroll平均分为（35.2±2.6）分；康复治疗后2个月Brunnstrom分级为IV级或V级，Caroll平均分为（85.6±4.6）分。结论 功能磁共振分析镜像可对脑卒中偏瘫患者康复前后大脑再塑变化进行全面地反映，可作为康复治疗的依据，值得临床推广使用。Objective:Functional magnetic resonance imaging was used to observe post stroke and rehabilitation process, changes in brain activation function area were analyzed, and cortical remodeling performance in different motor patterns were discussed. Methods: 30 cases of stroke patients during July 2012 to July 2013 were collected. They were receiving rehabilitation treatment for two months after onset. Hand function before and after rehabilitation was evaluated according to Brunnstrom and Carroll scale of upper limb function. Changes in blood oxygen levels after mirror treatment were observed. Functional imaging activation was examined by GE MR/iHSpeed 1.5 . Patients perform simple hand movement and other volitional movements, images were obtained about brain function activation, and activation of brain functional areas were observed. Results: Patients were at Grade III of Brunnstrom before rehabilitation treatment, and Caroll average (3.5±1.3) points. Brunnstrom graded as grade III or IV, Caroll average (35.2±2.6) points after rehabilitation treatment for one month. Brunnstrom graded as grade IV or V, Caroll average (85.6±4.6) points after rehabilitation treatment for two months. Conclusion: Functional magnetic resonance could wholly reflect remodeling changes of stroke patients before and after rehabilitation. It could be used as a basis for rehabilitation treatment, and it’s worthy of clinic application
