Diagnostic Yield of Diffusion-Weighted Brain Magnetic Resonance Imaging in Patients with Transient Global Amnesia: A Systematic Review and Meta-Analysis

ABSTRACT

Objective@#To investigate the diagnostic yield of diffusion-weighted imaging (DWI) in patients with transient global amnesia (TGA) and identify significant parameters affecting diagnostic yield. @*Materials and Methods@#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. @*Results@#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%], p 24 to 96 hours could increase the diagnostic yield.