Strupp M, Brüning R, Wu R H, Deimling M, Reiser M, Brandt T
Department of Neurology, Klinikum Grosshadern, University of Munich, Germany.
Ann Neurol. 1998 Feb;43(2):164-70. doi: 10.1002/ana.410430206.
Prompted by the findings of previous studies with positron emission tomography and single photon emission computed tomography, which demonstrated hypoperfusion or hyperperfusion in the left temporal lobe in isolated patients with transient global amnesia (TGA), we compared the sensitivity of diffusion-weighted (DW) magnetic resonance imaging (MRI) with that of conventional T1- and T2-weighted MRI in patients with TGA. Ten patients with the typical syndrome of a pure TGA were included in the study. For all patients, a coronal DW sequence, a steady-state free precession (SSFP) sequence, and conventional T1- and T2-weighted turbo spin-echo sequences were obtained. Seven of the 10 patients had elevated signal intensity in the left hippocampal region on DW MRI; moreover, 3 of these 7 patients exhibited bilateral signal abnormality in this sequence. All conventional T1- and T2-weighted images as well as all follow-up studies were normal. The signal elevation in DW MRI correlates with a decrease in the interstitial space and with cellular edema in the temporal lobe during TGA. The underlying pathomechanism causing this cellular edema cannot be clearly outlined using DW MRI. Our data are, however, compatible with spreading depression. This is the first study to show that DW MRI is a sensitive MRI method for evaluating TGA, especially in the early stage of the disease.
先前正电子发射断层扫描和单光子发射计算机断层扫描研究的结果显示，孤立性短暂性全面性遗忘症（TGA）患者的左颞叶存在灌注不足或灌注过度，受此启发，我们比较了弥散加权（DW）磁共振成像（MRI）与传统T1加权和T2加权MRI对TGA患者的敏感性。本研究纳入了10例具有典型单纯TGA综合征的患者。对所有患者均进行了冠状位DW序列、稳态自由进动（SSFP）序列以及传统T1加权和T2加权快速自旋回波序列检查。10例患者中有7例在DW MRI上左海马区信号强度升高；此外，这7例患者中有3例在此序列上表现为双侧信号异常。所有传统T1加权和T2加权图像以及所有随访研究结果均正常。DW MRI上的信号升高与TGA期间颞叶间质间隙减小和细胞水肿有关。使用DW MRI无法明确导致这种细胞水肿的潜在病理机制。然而，我们的数据与扩散性抑制相符。这是第一项表明DW MRI是评估TGA的敏感MRI方法的研究，尤其是在疾病早期。
