Förster A, Ramos Ana, Wenz H, Böhme J, Groden C, Alonso A
Department of Neuroradiology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
Department of Neuroradiology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
J Neuroradiol. 2022 May;49(3):244-249. doi: 10.1016/j.neurad.2021.03.007. Epub 2021 Apr 6.
Gadolinium leakage in ocular structures (GLOS) on fluid attenuated inversion recovery images (FLAIR) is a novel imaging marker in acute ischemic stroke and other neurological disorders.
In patients with transient neurovascular symptoms who underwent repeated MRI with intravenous contrast agent administration, the presence of acute ischemic lesions on diffusion-weighted images (DWI) as well as the frequency and pattern of blood-brain barrier and blood-retina barrier impairment as demonstrated by the hyperintense acute reperfusion marker (HARM) and GLOS respectively on postcontrast FLAIR were evaluated.
Overall 28 patients with transient neurovascular symptoms (median age 70.5 years; 18 (64.3%) male) were included. Follow-up MRI was performed within 35 (IQR 21-47) hours after the initial MRI. On DWI, acute ischemic lesions were observed in 22 (78.6%). On contrast-enhanced FLAIR, GLOS was observed in 12 (42.9%) patients: in 1 (3.6%) only in the anterior chamber, and in 11 (39.3%) in the anterior chamber and vitreous body. HARM was observed in 3 (10.7%) patients. In one patient without ischemic lesion on DWI or HARM on FLAIR, GLOS was observed in the anterior chamber and vitreous body. Presence of GLOS was associated with higher age (p = 0.04) and detection of HARM (p = 0.03).
In patients with transient neurovascular symptoms, GLOS is a frequent finding and associated with HARM on contrast-enhanced FLAIR. As GLOS was observed in one patient without an ischemic lesion or HARM, it might be useful as an additional imaging marker.
液体衰减反转恢复序列（FLAIR）图像上眼内结构钆渗漏（GLOS）是急性缺血性卒中及其他神经系统疾病的一种新型成像标志物。
对接受静脉注射造影剂后重复MRI检查的短暂性神经血管症状患者，评估弥散加权成像（DWI）上急性缺血性病变的存在情况，以及造影剂增强后FLAIR上分别由高强度急性再灌注标志物（HARM）和GLOS所显示的血脑屏障和血视网膜屏障损伤的频率及模式。
共纳入28例短暂性神经血管症状患者（中位年龄70.5岁；18例（64.3%）为男性）。在初次MRI检查后35（四分位间距21 - 47）小时内进行了随访MRI检查。在DWI上，22例（78.6%）观察到急性缺血性病变。在造影剂增强FLAIR上，12例（42.9%）患者观察到GLOS：1例（3.6%）仅在前房，11例（39.3%）在前房和玻璃体。3例（10.7%）患者观察到HARM。在1例DWI上无缺血性病变且FLAIR上无HARM的患者中，在前房和玻璃体观察到GLOS。GLOS的存在与较高年龄（p = 0.04）及HARM的检测（p = 0.03）相关。
在短暂性神经血管症状患者中，GLOS是常见表现且与造影剂增强FLAIR上的HARM相关。由于在1例无缺血性病变或HARM的患者中观察到了GLOS，它可能作为一种额外的成像标志物有用。
