Universität zu Köln

Steffen, Paul ORCID: 0000-0001-7057-9917, Beyer, Lara-Sophie, McDonough, Rosalie, Thaler, Christian, Faizy, Tobias, Fiehler, Jens, Gbadamosi, Joystone, Habermann, Christian R. and Schoenfeld, Michael H. (2021). Improved Detectability of Brain Stem Ischemia by Combining Axial and Coronal Diffusion-Weighted Imaging. Stroke, 52 (5). S. 1843 - 1847. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1524-4628

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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 kappa 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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Steffen, Paul UNSPECIFIED orcid.org/0000-0001-7057-9917 UNSPECIFIED Beyer, Lara-Sophie UNSPECIFIED UNSPECIFIED UNSPECIFIED McDonough, Rosalie UNSPECIFIED UNSPECIFIED UNSPECIFIED Thaler, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Faizy, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Fiehler, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Gbadamosi, Joystone UNSPECIFIED UNSPECIFIED UNSPECIFIED Habermann, Christian R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schoenfeld, Michael H. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-583419
DOI:	10.1161/STROKEAHA.120.032457
Journal or Publication Title:	Stroke
Volume:	52
Number:	5
Page Range:	S. 1843 - 1847
Date:	2021
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1524-4628
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STROKE; MR; DIAGNOSIS Multiple languages Clinical Neurology; Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58341