Value of Combination of Standard Axial and Thin-Section Coronal Diffusion-weighted Imaging in Diagnosis of Acute Brainstem Infarction

Nashwan I. Khaleel; Muna A. G. Zghair; Qays A. Hassan

doi:10.3889/oamjms.2019.336

Authors

Nashwan I. Khaleel Department of Radiology, Al-Yarmook Teaching Hospital, Baghdad, Iraq
Muna A. G. Zghair Division of Radiology, Department of Medicine, College of Medicine, Al-Mustansiriyah University, Baghdad, Iraq
Qays A. Hassan Division of Radiology, Department of Surgery, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

DOI:

https://doi.org/10.3889/oamjms.2019.336

Keywords:

Brainstem, Axial, Coronal, DWI, Stroke

Abstract

AIM: To determine the value of the combination of thin-section 3 mm â€Žcoronal and standard â€Žaxial DWI and their impact in facilitating the diagnosis of â€Žâ€Žacute brainstem infarction.

METHODS: A cross-sectional study conducted from the 1st of April 2017 to the end of February 2018 on 100 consecutive patients (66% were male, and 34% were female) with isolated acute ischemic infarction in the â€Žbrainstem. The abnormal MRI findings concerning the ischemic lesions were interpreted on standard axial 5 mm and thin-section coronal 3mm DWI.

RESULTS: The mean age of the studied group was 69.2 Â± 4.3 for male and 72.3 Â± 2.5 years. The standard axial DWI can diagnose 20%, 6.7% and 6.7% of the infarctions in midbrain, pons and medulla oblongata respectively, while both axial and thin coronal sections together can diagnose 80% of midbrain infarctions, 93.3% of pons infarctions and 93.3% of medulla oblongata infarctions. Furthermore, the thin section coronal 3 mm section can diagnose very smaller ischemic lesion volume in comparison to the standard axial 5mm section (3.4 Â± 0.45 / cm³ versus 4.6 Â± 0.23 / cm³, P < 0.001)

CONCLUSION: The addition of thin-section coronal DWI can facilitate the detection of brainstem ischemic lesions. We suggest its inclusion in the stroke MRI protocol.