ArticlePloS one2018
Improved detectability of acute and subacute brainstem infarctions by combining standard axial and thin-sliced sagittal DWI.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 32 citations in OpenAlex.
- Symptom-Only Localization of Brainstem Ischemia Using Large Language Models Versus Neurologists in Diffusion-Weighted Imaging-Positive Cases: Retrospective Single-Center Study.JMIR formative research · 2026Article
- [Ischemic stroke in dengue: Are we facing an immunomediated response? A case report]Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina) · 2026Article
- Combining Coronal and Axial DWI for Accurate Diagnosis of Brainstem Ischemic Strokes: Volume-Based Correlation with Stroke Severity.Brain sciences · 2025Article
- Detectability of acute ischemic stroke with thin (3 mm) axial versus thin (3 mm) coronal diffusion-weighted imaging in patients presenting to the emergency department with acute dizziness.Emergency radiology · 2025Article
- Optimal timing of ultra-early diffusion-weighted MRI in out-of-hospital cardiac arrest patients based on a retrospective multicenter cohort study.Scientific reports · 2024Article
- Clinical applications of diffusion-weighted sequence in brain imaging: beyond stroke.Neuroradiology · 2022Review
- Isolated trochlear palsy as the only presentation of midbrain infarction: a case report.The Journal of international medical research · 2021Article
- Diffuse astrocytoma and the diagnostic dilemma of an unusual phenotype: A case report.Radiology case reports · 2021Article
- Patient characteristics with negative diffusion-weighted imaging findings in acute lateral medullary infarction.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021Article
- Characteristics and resource needs in patients with vestibular symptoms: a comparison of patients with symptoms of unknown versus determined origin.BMC emergency medicine · 2020Article
- Sagittal diffusion-weighted imaging in preventing the false-negative diagnosis of acute brainstem infarction: Confirmation of the benefit by anatomical characterization of false-negative lesions.Surgical neurology international · 2019Article
- Application value of isotropic acquisition with simultaneous multi-slice diffusion weighted imaging in subacute early small artery occlusive cerebral infarction.Frontiers in neurologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeMost false negative findings in DWI of ischemic stroke are in patients with minor deficits clinically localized to the brainstem. Our goal was to evaluate the benefit of a thin-sliced sagittal DWI in addition to conventional axial DWI at 1.5T for the detection of brainstem infarctions.
methodsData of patients with symptoms consistent with acute and subacute brainstem infarction and an MRI examination including standard axial DWI and thin-sliced sagittal DWI were retrospectively analyzed. Patients with the later diagnosis of a TIA, an inflammation or a tumor of the brainstem were excluded from analysis. Diffusion restrictions were identified by two independent raters blinded for the final clinical diagnosis in three separate reading steps: First, only axial DWI, secondly only sagittal DWI, and lastly both DWIs together. Presence and size of DWI-lesions were documented for each plane. Differences between the observers were settled in consensus in a separate joint reading.
resultsOf 73 included patients, 46 patients were clinically diagnosed with brainstem infarction. Inter-observer agreement was excellent for the detection of brainstem lesions in axial and sagittal DWI (kappa = 0.94 and 0.97). In 28/46 patients (60.9%) lesions were detected in the axial plane alone, whereas in 6 more patients (73.9%) lesions were detected in the review of both sequences together. All lesions undetectable in the axial plane were smaller than 5 mm in cranio-caudal direction.
conclusionsThin-sliced sagittal DWI in addition to axial DWI improves the detection rate of brainstem infarction with little additional expenditure of time.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.