Usefulness and Clinical Significance of Thin-slice Gapless Coronal Diffusion-weighted Imaging for Acute Brainstem Infarction Diagnosis

• Published in: Japanese Journal of Radiological Technology Vol. 77; no. 10; pp. 1203 - 1208
• Main Author: Koori, Norikazu
• Format: Journal Article
• Language: English; Japanese
• Published: Kyoto Japanese Society of Radiological Technology 2021; Japan Science and Technology Agency
• Subjects: acute brainstem infarction; Axial diffusion; Brain stem; Cerebral infarction; Clinical significance; coronal DWI; Diagnosis; Diffusion coefficient; diffusion-weighted image(DWI); Evaluation; Infarction; magnetic resonance imaging; Medical imaging; Patients; thin-slice gapless
• ISSN: 0369-4305; 1881-4883
• DOI: 10.6009/jjrt.2021_JSRT_77.10.1203

Background: The lesions caused by brainstem infarction are usually small. Therefore, it is often difficult to diagnose them using axial diffusion-weighted imaging (axial DWI). The purpose of this study was to evaluate the usefulness of thin-slice gapless coronal DWI in acute brainstem infarction diagnosis by difference of elapsed time from the onset of cerebral infarction. Methods: Axial DWI and coronal DWI were performed in 90 patients (mean age: 70.0±12.5 years) with acute brainstem infarction. Patients were classified into four groups according to the elapsed time after the onset of brainstem infarction: <3 h (group A), 3–10 h (group B), 10–30 h (group C), and ≥30 h (group D). We compared axial DWI and coronal DWI in terms of visual evaluation score, apparent diffusion coefficient (ADC) value, and contrast in the four groups. Results: The visual evaluation scores were significantly higher using coronal DWI in groups A, B, and C than in group D. The ADC values in groups C and D were significantly higher in coronal DWI. The contrast in groups C and D was significantly higher in coronal DWI. Conclusion: Coronal DWI is especially useful for acute brainstem infarction diagnosis within 30 hours of its onset.