Khaleel Nashwan I, Zghair Muna A G, Hassan Qays A
Department of Radiology, Al-Yarmook Teaching Hospital, Baghdad, Iraq.
Division of Radiology, Department of Medicine, College of Medicine, Al-Mustansiriyah University, Baghdad, Iraq.
Open Access Maced J Med Sci. 2019 Jul 28;7(14):2287-2291. doi: 10.3889/oamjms.2019.336. eCollection 2019 Jul 30.
To determine the value of the combination of thin-section 3 mm coronal and standard axial DWI and their impact in facilitating the diagnosis of acute brainstem infarction.
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 brainstem. The abnormal MRI findings concerning the ischemic lesions were interpreted on standard axial 5 mm and thin-section coronal 3mm DWI.
The mean age of the studied group was 69.2 ± 4.3 for male and 72.3 ± 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 ± 0.45 / cm versus 4.6 ± 0.23 / cm, P < 0.001).
The addition of thin-section coronal DWI can facilitate the detection of brainstem ischemic lesions. We suggest its inclusion in the stroke MRI protocol.
确定3毫米薄层冠状位与标准轴位弥散加权成像（DWI）联合应用的价值及其对急性脑干梗死诊断的促进作用。
2017年4月1日至2018年2月底对100例连续的孤立性急性脑干缺血性梗死患者进行横断面研究（66%为男性，34%为女性）。在标准轴位5毫米和薄层冠状位3毫米DWI上解读有关缺血性病变的异常MRI表现。
研究组男性平均年龄为69.2±4.3岁，女性为72.3±2.5岁。标准轴位DWI分别能诊断中脑、脑桥和延髓梗死的20%、6.7%和6.7%，而轴位和薄层冠状位联合应用能诊断80%的中脑梗死、93.3%的脑桥梗死和93.3%的延髓梗死。此外，与标准轴位5毫米层面相比，3毫米薄层冠状位层面能诊断出体积更小的缺血性病变（3.4±0.45/cm对4.6±0.23/cm，P<0.001）。
增加薄层冠状位DWI有助于检测脑干缺血性病变。我们建议将其纳入卒中MRI检查方案。
