短暂性全面遗忘症海马扩散加权成像扩散受限患者特征性分析  

Analysis of characteristic abnormalities of hippocampal diffusion weighted imaging in patient with transient global amnesia

作　　者：张志勇 孙士龙[2] 周知[3] 王磊[1] 张艳丽[1] 德杰[4] 刘志勤[5] 焦劲松[3] ZHANG Zhiyong;SUN Shilong;ZHOU Zhi;WANG Lei;ZHANG Yanli;DE Jie;LIU Zhiqin;JIAO Jinsong(Department of Neurology,Beijing Geriatric Hospital,Beijing 100095,China;Department of Radiology,China-Japan Friendship Hospital,Beijing 100029,China;Department of Neurology,China-Japan Friendship Hospital,Beijing 100029,China;Department of Radiology,Beijing Geriatric Hospital,Beijing 100095,China;Department of Neurology,Xi’an Central Hospital,Xi’an Jiaotong University,Xi’an 710003,China)

机构地区：[1]北京老年医院神经内科,北京100095 [2]中日友好医院放射科,北京100029 [3]中日友好医院神经内科,北京100029 [4]北京老年医院放射科,北京100095 [5]西安交通大学附属西安市中心医院神经内科,陕西西安710003

出　　处：《实用放射学杂志》2023年第6期875-878,共4页Journal of Practical Radiology

基　　金：北京老年医院老年医学科研专项项目(2021bjlnyy-重-1);陕西省重点研发计划项目(2022SF-483)。

摘　　要：目的探讨短暂性全面遗忘症(TGA)扩散加权成像(DWI)序列上海马扩散受限患者的临床及影像学特征。方法选取46例临床确诊的TGA患者,依据DWI序列上海马有无扩散受限分为海马病变组与海马无病变组,比较2组患者的临床、影像学及随访资料。结果46例TGA患者海马病变组28例(60.9%)、海马无病变组18例(39.1%)。56.5%的患者病前有诱因,经比较海马病变组比海马无病变组有更明确的诱因(P=0.011)。TGA发病后在24~72 h行MRI者占多数(60.9%),经比较海马病变组比海马无病变组在24~72 h扫描占比更高(P=0.011),且经比较显示海马病变组比海马无病变组DWI薄层横轴位联合冠状位扫描比例更高(P=0.040)。6个月随访期内无卒中事件发生,TGA复发4例(8.7%),经比较2组间TGA复发率无差异(P=0.639)。结论多数TGA患者存在海马扩散受限,且其发病前常有诱因。海马DWI病变的检出可能受扫描时机及DWI成像方式影响,但海马病变对TGA预后无明显影响。Objective To investigate the clinical and radiographic characteristics of transient global amnesia(TGA)patients with hippocampal diffusion weighted imaging(DWI)abnormalities.Methods A total of 46 patients with TGA confirmed by clinical were selected and were further divided into two groups,including hippocampal lesion group and hippocampal non-lesion group according to the DWI sequence.The clinical,imaging and follow-up data were compared between the two groups.Results Of all 46 patients with TGA,there were 28 cases(60.9%)in the hippocampal lesion group and 18 cases(39.1%)in the hippocampal non-lesion group.There were 56.5% patients with definite predisposing factors before onset,and compared with the hippocampal non-lesion group,hippocampal lesion group had more significant definite predisposing factors(P=0.011).Most patients(60.9%)underwent MRI at 24-72 hours after TGA onset.The proportion of performing MRI at 24-72 hours after TGA onset in the hippocampal lesion group was significantly higher than that in the hippocampal non-lesion group(P=0.011).The proportion of the thin-slice DWI scan with coronal and axial section in the hippocampal lesion group was significantly higher than those in the hippocampal non-lesion group(P=0.040).There were no stroke events among all patients,and only 4 TGA patients(8.7%)with recurrence within 6 months.There was no difference in TGA recurrence between the two groups(P=0.639).Conclusion Many TGA patients have hippocampal diffusion restriction on DWI,who often have definite predisposing factors before onset.In addition,the detection of hippocampal DWI lesion may be affected by the time from the MRI scan to the onset of TGA and the DWI reconstruction patterns,with no significant impact on the overall prognosis of TGA.

关 键 词：短暂性全面遗忘症 海马 扩散加权成像 预后 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]