Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
University of Ulsan College of Medicine, Seoul, Korea.
Korean J Radiol. 2021 Oct;22(10):1680-1689. doi: 10.3348/kjr.2020.1462. Epub 2021 Jul 14.
To investigate the diagnostic yield of diffusion-weighted imaging (DWI) in patients with transient global amnesia (TGA) and identify significant parameters affecting diagnostic yield.
A systematic literature search of the MEDLINE and EMBASE databases was conducted to identify studies that assessed the diagnostic yield of DWI in patients with TGA. The pooled diagnostic yield of DWI in patients with TGA was calculated using the DerSimonian-Laird random-effects model. Subgroup analyses were also performed of slice thickness, magnetic field strength, and interval between symptom onset and DWI.
Twenty-two original articles (1732 patients) were included. The pooled incidence of right, left, and bilateral hippocampal lesions was 37% (95% confidence interval [CI], 30-44%), 42% (95% CI, 39-46%), and 25% (95% CI, 20-30%) of all lesions, respectively. The pooled diagnostic yield of DWI in patients with TGA was 39% (95% CI, 27-52%). The Higgins I² statistic showed significant heterogeneity (I² = 95%). DWI with a slice thickness ≤ 3 mm showed a higher diagnostic yield than DWI with a slice thickness > 3 mm (pooled diagnostic yield: 63% [95% CI, 53-72%] vs. 26% [95% CI, 16-40%], < 0.01). DWI performed at an interval between 24 and 96 hours after symptom onset showed a higher diagnostic yield (68% [95% CI, 57-78%], < 0.01) than DWI performed within 24 hours (16% [95% CI, 7-34%]) or later than 96 hours (15% [95% CI, 8-26%]). There was no difference in the diagnostic yield between DWI performed using 3T vs. 1.5T (pooled diagnostic yield, 31% [95% CI, 25-38%] vs. 24% [95% CI, 14-37%], = 0.31).
The pooled diagnostic yield of DWI in TGA patients was 39%. DWI obtained with a slice thickness ≤ 3 mm or an interval between symptom onset and DWI of > 24 to 96 hours could increase the diagnostic yield.
探讨磁共振扩散加权成像（DWI）在短暂性全面遗忘症（TGA）患者中的诊断效能，并确定影响诊断效能的显著参数。
系统检索 MEDLINE 和 EMBASE 数据库，以评估 DWI 在 TGA 患者中的诊断效能的研究。采用 DerSimonian-Laird 随机效应模型计算 TGA 患者 DWI 的总体诊断效能。还对层厚、磁场强度和症状发作与 DWI 之间的时间间隔进行了亚组分析。
共纳入 22 篇原始文章（1732 例患者）。右侧、左侧和双侧海马病变的总发生率分别为 37%（95%置信区间[CI]，30-44%）、42%（95%CI，39-46%）和 25%（95%CI，20-30%）。TGA 患者 DWI 的总体诊断效能为 39%（95%CI，27-52%）。Higgins I² 统计量显示存在显著异质性（I²=95%）。层厚≤3mm 的 DWI 比层厚＞3mm 的 DWI 具有更高的诊断效能（总体诊断效能：63%[95%CI，53-72%]比 26%[95%CI，16-40%]，＜0.01）。症状发作后 24 至 96 小时内进行的 DWI 诊断效能较高（68%[95%CI，57-78%]，＜0.01），而在 24 小时内（16%[95%CI，7-34%]）或 96 小时后（15%[95%CI，8-26%]）进行的 DWI 诊断效能较低。3T 与 1.5T 场强下 DWI 的诊断效能无差异（总体诊断效能：31%[95%CI，25-38%]比 24%[95%CI，14-37%]，=0.31）。
TGA 患者 DWI 的总体诊断效能为 39%。采用层厚≤3mm 或症状发作与 DWI 之间的时间间隔＞24 至 96 小时进行 DWI 可提高诊断效能。
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