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

Abstract

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. 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. 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. Coronal DWI is especially useful for acute brainstem infarction diagnosis within 30 hours of its onset.