Improved Detectability of Brain Stem Ischemia by Combining Axial and Coronal Diffusion-Weighted Imaging
| Autor: | Rosalie McDonough, Christian R. Habermann, Tobias D Faizy, Joystone Gbadamosi, Lara-Sophie Beyer, Michael Schönfeld, Christian J. Thaler, Paul Steffen, Jens Fiehler |
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| Rok vydání: | 2021 |
| Předmět: |
Brain Stem Infarctions
Ischemia Infarction Sensitivity and Specificity 030218 nuclear medicine & medical imaging 03 medical and health sciences Brain stem infarction 0302 clinical medicine Nuclear magnetic resonance medicine Humans cardiovascular diseases Diffusion (business) Retrospective Studies Advanced and Specialized Nursing medicine.diagnostic_test business.industry Magnetic resonance imaging medicine.disease Diffusion Magnetic Resonance Imaging Coronal plane Brain stem ischemia Neurology (clinical) Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery Diffusion MRI Brain Stem |
| Zdroj: | Stroke. 52(5) |
| ISSN: | 1524-4628 |
| Popis: | Background and Purpose: To evaluate the benefit of a coronal diffusion-weighted imaging (DWI) in addition to standard axial DWI for the detection of brain stem infarctions. Methods: A retrospective analysis of patients with symptoms consistent with acute and subacute brain stem infarction who received magnetic resonance imaging, including axial and coronal DWI. Diffusion restrictions were identified by 2 independent raters blinded for the final clinical diagnosis in 3 separate reading steps: axial DWI, coronal DWI, and combined axial and coronal DWI. Lesion location and certainty level were both documented for each reading step. In cases of reader disagreement, an additional consensus reading was performed. Results: Two hundred thirty-nine patients were included. Of these, 124 patients (51.9%) were clinically diagnosed with brain stem infarction. Sensitivity, specificity, positive, and negative predictive values were best for combined DWI assessment (90.3%, 99.1%, 99.1%, and 90.5%) compared with axial (85.5%, 94.9%, 94.6%, and 85.8%) and coronal DWI alone (87.9%, 96.5%, 96.5%, and 88.1%). Diffusion restriction on combined DWI was diagnosed in 112/124 patients compared with 106/124 on axial DWI and 109/124 on coronal DWI. Interobserver agreement for the detection of brain stem lesions was the highest in the combined rating step (Cohen κ coefficient=0.94). Conclusions: Coronal DWI sequences might improve the detection rate of brain stem infarction compared with standard axial DWI. The combined coronal and axial DWI provides the best detection rate while minimally increasing scan times. |
| Databáze: | OpenAIRE |
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