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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, Vol. 52, No. 5, 05.2021, p. 1843-1846.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Steffen, P, Beyer, L-S, McDonough, R, Thaler, C, Faizy, T, Fiehler, J, Gbadamosi, J, Habermann, CR & Schönfeld, MH 2021, 'Improved Detectability of Brain Stem Ischemia by Combining Axial and Coronal Diffusion-Weighted Imaging', STROKE, vol. 52, no. 5, pp. 1843-1846. https://doi.org/10.1161/STROKEAHA.120.032457

APA

Steffen, P., Beyer, L-S., McDonough, R., Thaler, C., Faizy, T., Fiehler, J., Gbadamosi, J., Habermann, C. R., & Schönfeld, M. H. (2021). Improved Detectability of Brain Stem Ischemia by Combining Axial and Coronal Diffusion-Weighted Imaging. STROKE, 52(5), 1843-1846. https://doi.org/10.1161/STROKEAHA.120.032457

Vancouver

Steffen P, Beyer L-S, McDonough R, Thaler C, Faizy T, Fiehler J et al. Improved Detectability of Brain Stem Ischemia by Combining Axial and Coronal Diffusion-Weighted Imaging. STROKE. 2021 May;52(5):1843-1846. https://doi.org/10.1161/STROKEAHA.120.032457

Bibtex

@article{0575b8086ff44c2d96343ff8a2484ec2,
title = "Improved Detectability of Brain Stem Ischemia by Combining Axial and Coronal Diffusion-Weighted Imaging",
abstract = "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.",
keywords = "Brain Stem/diagnostic imaging, Brain Stem Infarctions/diagnostic imaging, Diffusion Magnetic Resonance Imaging/methods, Humans, Retrospective Studies, Sensitivity and Specificity",
author = "Paul Steffen and Lara-Sophie Beyer and Rosalie McDonough and Christian Thaler and Tobias Faizy and Jens Fiehler and Joystone Gbadamosi and Habermann, {Christian R} and Sch{\"o}nfeld, {Michael H}",
year = "2021",
month = may,
doi = "10.1161/STROKEAHA.120.032457",
language = "English",
volume = "52",
pages = "1843--1846",
journal = "STROKE",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

RIS

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 -