Förster Alex, Al-Zghloul Mansour, Kerl Hans U, Böhme Johannes, Mürle Bettina, Groden Christoph
Department of Neuroradiology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
PLoS One. 2015 Mar 24;10(3):e0122537. doi: 10.1371/journal.pone.0122537. eCollection 2015.
Transient global amnesia (TGA) is a transitory, short-lasting neurological disorder characterized by a sudden onset of antero- and retrograde amnesia. Perfusion abnormalities in TGA have been evaluated mainly by use of positron emission tomography (PET) or single-photon emission computed tomography (SPECT). In the present study we explore the value of dynamic susceptibility contrast perfusion-weighted MRI (PWI) in TGA in the acute phase.
From a MRI report database we identified TGA patients who underwent MRI including PWI in the acute phase and compared these to control subjects. Quantitative perfusion maps (cerebral blood flow (CBF) and volume (CBV)) were generated and analyzed by use of Signal Processing In NMR-Software (SPIN). CBF and CBV values in subcortical brain regions were assessed by use of VOI created in FIRST, a model-based segmentation tool in the Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB) Software Library (FSL).
Five TGA patients were included (2 men, 3 women). On PWI, no relevant perfusion alterations were found by visual inspection in TGA patients. Group comparisons for possible differences between TGA patients and control subjects showed significant lower rCBF values bilaterally in the hippocampus, in the left thalamus and globus pallidus as well as bilaterally in the putamen and the left caudate nucleus. Correspondingly, significant lower rCBV values were observed bilaterally in the hippocampus and the putamen as well as in the left caudate nucleus. Group comparisons for possible side differences in rCBF and rCBV values in TGA patients revealed a significant lower rCBV value in the left caudate nucleus.
Mere visual inspection of PWI is not sufficient for the assessment of perfusion changes in TGA in the acute phase. Group comparisons with healthy control subjects might be useful to detect subtle perfusion changes on PWI in TGA patients. However, this should be confirmed in larger data sets and serial PWI examinations.
短暂性全面性遗忘症（TGA）是一种短暂的、持续时间较短的神经系统疾病，其特征为突然发作的顺行性和逆行性遗忘。TGA中的灌注异常主要通过正电子发射断层扫描（PET）或单光子发射计算机断层扫描（SPECT）进行评估。在本研究中，我们探讨了动态磁敏感对比灌注加权磁共振成像（PWI）在TGA急性期的价值。
从MRI报告数据库中，我们识别出在急性期接受了包括PWI在内的MRI检查的TGA患者，并将其与对照组进行比较。通过使用核磁共振信号处理软件（SPIN）生成并分析定量灌注图（脑血流量（CBF）和脑血容量（CBV））。通过使用在FIRST中创建的感兴趣区（VOI）评估皮质下脑区的CBF和CBV值，FIRST是牛津大学脑功能磁共振成像中心（FMRIB）软件库（FSL）中的一种基于模型的分割工具。
纳入了5例TGA患者（2例男性，3例女性）。在PWI上，通过肉眼观察未在TGA患者中发现相关的灌注改变。对TGA患者和对照组之间可能存在的差异进行组间比较，结果显示双侧海马、左侧丘脑和苍白球以及双侧壳核和左侧尾状核的相对脑血流量（rCBF）值显著降低。相应地，双侧海马、壳核以及左侧尾状核的相对脑血容量（rCBV）值显著降低。对TGA患者rCBF和rCBV值可能存在的侧别差异进行组间比较，结果显示左侧尾状核的rCBV值显著降低。
仅通过肉眼观察PWI不足以评估TGA急性期的灌注变化。与健康对照组进行组间比较可能有助于检测TGA患者PWI上的细微灌注变化。然而，这一点应在更大的数据集中以及连续的PWI检查中得到证实。
