Improved Detectability of Brain Stem Ischemia by Combining Axial and Coronal Diffusion-Weighted Imaging
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Improved Detectability of Brain Stem Ischemia by Combining Axial and Coronal Diffusion-Weighted Imaging. / Steffen, Paul; Beyer, Lara-Sophie; McDonough, Rosalie; Thaler, Christian; Faizy, Tobias; Fiehler, Jens; Gbadamosi, Joystone; Habermann, Christian R; Schönfeld, Michael H.
in: STROKE, Jahrgang 52, Nr. 5, 05.2021, S. 1843-1846.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Improved Detectability of Brain Stem Ischemia by Combining Axial and Coronal Diffusion-Weighted Imaging
AU - Steffen, Paul
AU - Beyer, Lara-Sophie
AU - McDonough, Rosalie
AU - Thaler, Christian
AU - Faizy, Tobias
AU - Fiehler, Jens
AU - Gbadamosi, Joystone
AU - Habermann, Christian R
AU - Schönfeld, Michael H
PY - 2021/5
Y1 - 2021/5
N2 - 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.
AB - 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.
KW - Brain Stem/diagnostic imaging
KW - Brain Stem Infarctions/diagnostic imaging
KW - Diffusion Magnetic Resonance Imaging/methods
KW - Humans
KW - Retrospective Studies
KW - Sensitivity and Specificity
U2 - 10.1161/STROKEAHA.120.032457
DO - 10.1161/STROKEAHA.120.032457
M3 - SCORING: Journal article
C2 - 33813862
VL - 52
SP - 1843
EP - 1846
JO - STROKE
JF - STROKE
SN - 0039-2499
IS - 5
ER -