Charles P D, Abou-Khalil R, Abou-Khalil B, Wertz R T, Ashmead D H, Welch L, Kirshner H S
Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN 37212.
Neurology. 1994 Nov;44(11):2050-4. doi: 10.1212/wnl.44.11.2050.
To examine the relationship between language dominance, as measured by Wada testing, and hemispheric asymmetries on MR brain images.
A previous report that did not include verification of language dominance compared the length of the planum temporale with hemispheric asymmetries seen on CT and inferred that occipital lobe asymmetry is related to language dominance.
Language dominance was identified by the Wada test in 57 patients evaluated for surgical treatment of epilepsy. Fifty-five had an MRI scan that allowed accurate measurement. In a blinded fashion, two examiners independently measured bilateral frontal, parietal, and occipital lobe lengths on MR scan for each patient. Measurements of asymmetries were compared with language dominance established by the Wada test.
Reliability of measurement between the examiners was 97%. Asymmetry of the occipital lobe length on MR scan 10 mm above the tentorium was the only measurement significantly related to language dominance (p < 0.01). Occipital lobe length was longer on the left in 19 (40%) and on the right in 10 (21%) patients with left dominance. The right lobe was longer in six of seven (86%) patients with bilateral dominance. One patient with right hemisphere dominance had a longer left lobe. None of the measurements significantly related to handedness.
Asymmetries of occipital lobe length relate to language dominance, but such dominance cannot be reliably identified by MR in an individual patient.
通过Wada测试来检测语言优势与脑部磁共振成像（MRI）上的半球不对称性之间的关系。
之前一份未对语言优势进行验证的报告，比较了颞平面的长度与CT上所见的半球不对称性，并推断枕叶不对称与语言优势有关。
对57例接受癫痫手术治疗评估的患者进行Wada测试以确定语言优势。其中55例进行了MRI扫描，以便进行精确测量。两位检查者以盲法独立测量每位患者MRI扫描上双侧额叶、顶叶和枕叶的长度。将不对称性测量结果与通过Wada测试确定的语言优势进行比较。
检查者之间测量的可靠性为97%。在小脑幕上方10毫米处的MRI扫描上，枕叶长度的不对称是唯一与语言优势显著相关的测量指标（p < 0.01）。在19例（40%）左侧语言优势的患者中，左侧枕叶长度更长；在10例（21%）左侧语言优势的患者中，右侧枕叶长度更长。在7例（86%）双侧语言优势的患者中，有6例右侧枕叶更长。1例右侧半球语言优势的患者左侧枕叶更长。没有任何测量指标与利手显著相关。
枕叶长度的不对称与语言优势有关，但在个体患者中，无法通过MRI可靠地确定这种优势。
