Improved detectability of acute and subacute brainstem infarctions by combining standard axial and thin-sliced sagittal DWI

• DOI: 10.1371/journal.pone.0200092
• Publication Date: 2018-07-03T14:25:17Z
• Authors: Michael H. Schönfeld; Robert M. Ritzel; Andre Kemmling; Marielle Ernst; Jens Fiehler; Susanne Gellißen
• Keywords: Observer Variation; Brain Stem Infarctions; Science; Q; R; Sensitivity and Specificity; 03 medical and health sciences; Diffusion Magnetic Resonance Imaging; 0302 clinical medicine; Medicine; Humans; Research Article; Brain Stem; Retrospective Studies

Most false negative findings in DWI of ischemic stroke are patients with minor deficits clinically localized to the brainstem. Our goal was evaluate benefit a thin-sliced sagittal addition conventional axial at 1.5T for detection brainstem infarctions.Data symptoms consistent acute and subacute infarction an MRI examination including standard were retrospectively analyzed. Patients later diagnosis TIA, inflammation or tumor excluded from analysis. Diffusion restrictions identified by two independent raters blinded final clinical three separate reading steps: First, only DWI, secondly lastly both DWIs together. Presence size DWI-lesions documented each plane. Differences between observers settled consensus joint reading.Of 73 included patients, 46 diagnosed infarction. Inter-observer agreement excellent lesions (kappa = 0.94 0.97). In 28/46 (60.9%) detected plane alone, whereas 6 more (73.9%) review sequences All undetectable smaller than 5 mm cranio-caudal direction.Thin-sliced improves rate little additional expenditure time.