A multicenter study of transient global amnesia for the better detection of magnetic resonance imaging abnormalities

概要

〔目的(Purpose)〕
The detection rate of diffusion-weighted (DWI) hyperintense lesions varies widely in patients with transient global amnesia (TGA). We aimed to examine the association of hyperintense lesions on DWI magnetic resonance images (MRIs) with patient characteristics, precipitating factors, clinical presentation, and MRI settings in patients with TGA.

〔方法ならびに成績(Methods/Results)〕
Methods: In this multicenter retrospective observational study, using the standardized diagnosis entry system of electronic health records of four tertiary medical centers in the Kansai district of Japan, TGA patients (n=261) who underwent brain MRI within 28 days of onset were examined. When the onset time was unavailable, the discovery time was used.

Results: DWI hyperintense lesions were observed in 79 patients (30%). There were no significant differences in age, sex, vascular risk factors, precipitating factors, or clinical presentation between patients with and without DWI lesions. The detection rate increased linearly 24 h after onset and then reached a plateau of by 84 h. After 84 h, the detection rate decreased rapidly. In a multivariate logistic regression model, MRI examination 24-84 h after onset [odds ratio (OR) 7.00, 95% confidence interval (CI) 3. 50-13. 99] and a thin-slice (く3 mm) DWI sequence [OR 7. 59, 95% CI 3. 05-18. 88] were independent predictors of DWI lesions.

〔総括(Conclusion)〕
This study suggests that 1)there was no significant association between DWI hyperintense lesions and patient characteristics or clinical presentation, 2) DWI hyperintense lesions were frequently detected between 24 h and 84 h after TGA onset, and 3) the period between 24-84 h after TGA onset and a thin-slice DWI sequence (≦ 3 mm) were independent predictors of the presence of DWI hyperintense lesions.