Abstract: Background　Dysphagia has become an independent risk factor affecting the prognosis of stroke patients. There are few reports about the recovery mechanism of dysphagic patients after stroke using resting state functional magnetic resonance imaging（rsfMRI）．Objective　To analyze the relationship between functional magnetic resonance imaging and swallowing function in patients with dysphagia after cerebral infarction，so as to explore the probable mechanism of dysphagia after cerebral infarction.Methods　Twenty patients who were hospitalized from March to December 2016 in Department of Neurology，the First Affiliated Hospital of Guangxi Medical University were recruited.Meanwhile，twenty healthy volunteers who underwent a health checkup were included，serving as the controls.Both groups were performed cranial magnetic resonance imaging（MRI） and rsfMRI examinations.Amplitude of low frequency fluctuations （ALFF） was analyzed by DPARSF software.The video fluoroscopy swallowing study （VFSS），as well as the rosenbek penetration and aspiration scale were carried out among patients，in order to evaluate swallowing function.Those regions with lower ALFF values among patients were reviewed as the regions of interest （ROI）．Then the relationship between ROI and Rosenbek penetration/aspiration grade was analyzed.Results　After the exclusion of unqualified subjects，twelve patients and eighteen healthy controls were included finally.Compared to the controls，ALFF values of left anterior central gyrus，precentral gyrus，insular lobe and putamen were all lower among patients （ P<0.05），while ALFF values of right anterior cingulate，insular cortex，visual center and primary auditory cortex were all higher （ P<0.05）．The ROIs of left central anterior，central posterior，insular lobe and putamen of patients were marked as ROI1，ROI2，ROI3 and ROI4，respectively.The results of Pearson correlation analysis revealed that ROI1，ROI2，ROI3 and ROI4 were all positively correlated with Rosenbek osmotic/aspiration grade （rROI1=0.45，P=0.006；rROI2=0.34，P=0.017；rROI3=0.24，P=0.035；rROI4=0.18，P=0.043）．Conclusion　The ALFF value of patients with dysphagia after cerebral infarction is positively correlated with Rosenbek penetration/aspiration grade.The abnormality of brain function may be one of the probable mechanisms underlying dysphagia.

Key words: Cerebral infarction, Dysphagia, Magnetic resonance imaging, Correlation analysis

摘要： 背景　吞咽障碍已成为影响脑卒中患者预后的独立危险因素，鲜见通过静息态功能性磁共振成像（rsfMRI）研究吞咽障碍康复机制的相关报道。目的　分析脑梗死后吞咽障碍患者脑功能成像与吞咽功能的相关性，从而进一步了解脑梗死后吞咽障碍的发生机制。方法　选取2016年3—12月广西医科大学第一附属医院神经内科收治的脑梗死后吞咽障碍患者20例为病例组，选取同期本院体检健康的20例健康志愿者为对照组。两组均予以颅脑磁共振成像（MRI）及rsfMRI检查。通过DPARSF软件分析低频振幅（ALFF）值。病例组进行视频透视吞咽功能检查（VFSS），并采用Rosenbek渗透/误吸分级评估患者吞咽情况。以病例组ALFF值减低的脑区作为感兴趣区（ROI），分析ROI与Rosenbek渗透/误吸分级的相关性。结果　剔除rsfMRI检查过程中不合格的研究对象，实际进入研究病例组12例，对照组18例。与对照组比较，病例组左侧中央前回、中央后回、岛叶、壳核ALFF值降低（P<0.05）；与对照组比较，病例组右侧后扣带回、岛叶、视觉中枢、初级听皮质ALFF值升高（P<0.05）。病例组左侧中央前回、中央后回、岛叶、壳核的ROI分别记为ROI1、ROI2、ROI3、ROI4。Pearson相关分析结果显示，病例组ROI1、ROI2、ROI3、ROI4与Rosenbek渗透/误吸分级呈正相关（rROI1=0.45，P=0.006；rROI2=0.34，P=0.017；rROI3=0.24，P=0.035；rROI4=0.18，P=0.043）。结论　脑梗死后吞咽障碍患者静息态ALFF值与Rosenbek渗透/误吸分级呈正相关，这可能是吞咽障碍发生机制之一。

关键词: 脑梗死, 吞咽障碍, 磁共振成像, 相关分析