Evidence map›Paper›PMID 40053160›Full record

ArticleEmergency radiology2025

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.

Richard J Lozano, Faryal Shareef, Anish Neupane, Zaid Siddique, Rudra Joshi, Luca Pasquini, Long H Tu, Amit Mahajan

Erratum issuedAbstract readComparative Study
PubMed Publisher
In one paragraph

Article in Emergency radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Richard J Lozano *Department of Radiology and Biomedical Imaging, Yale School of Medicine, Tompkin's East 2, PO Box 208042, New Haven, CT, 06520, USA.
Faryal Shareef *Department of Radiology and Biomedical Imaging, Yale School of Medicine, Tompkin's East 2, PO Box 208042, New Haven, CT, 06520, USA.
Anish NeupaneDepartment of Radiology, Bridgeport Hospital, 267 Grant St, Bridgeport, CT, 06610, USA.
Zaid SiddiqueDepartment of Radiology and Biomedical Imaging, Yale School of Medicine, Tompkin's East 2, PO Box 208042, New Haven, CT, 06520, USA.
Rudra JoshiDepartment of Radiology and Biomedical Imaging, Yale School of Medicine, Tompkin's East 2, PO Box 208042, New Haven, CT, 06520, USA.
Luca PasquiniDepartment of Radiology and Biomedical Imaging, Yale School of Medicine, Tompkin's East 2, PO Box 208042, New Haven, CT, 06520, USA.
Long H TuDepartment of Radiology and Biomedical Imaging, Yale School of Medicine, Tompkin's East 2, PO Box 208042, New Haven, CT, 06520, USA. long.tu@yale.edu.ORCID http://orcid.org/0000-0002-2419-5581
Amit MahajanDepartment of Radiology and Biomedical Imaging, Yale School of Medicine, Tompkin's East 2, PO Box 208042, New Haven, CT, 06520, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeIschemic strokes can cause vertigo, particularly when involving the posterior circulation of the brain. Prior research has suggested that thin-section (3 mm) axial or coronal DWI may improve the detection of ischemic stroke compared to thick (5 mm) DWI. However, relative sensitivity of differing thin DWI sequences is unknown. In this retrospective cohort study, we compare the sensitivity of thin coronal DWI and thin axial DWI in detection of brain ischemia. MATERIALS AND

methodsRetrospective study at a single institution (2/18/2020-8/31/2023) of patients who presented to the emergency department with vertigo/dizziness and underwent an abbreviated MRI protocol (3 mm axial DWI, 3 mm coronal DWI, axial FLAIR, and axial SWI). For each case with an ischemic lesion, the visibility of infarct on thin axial and coronal DWIs was rated; location and size were also recorded. Visibility on either sequence was considered the reference standard. Sensitivity was compared with McNemar's test.

results615 abbreviated MRI examinations were performed; 24/615 (3.9%) had an ischemic lesion (15 cerebral, 7 brainstem, 13 cerebellar). 24 of these MRI examinations with ischemic lesions were performed using 3 mm axial MRI and on 3T MRI. All lesions (24/24) were visible on thin axial DWI (100% sensitivity, 95% CI: 0.95-1.00). Fewer lesions (20/24) were seen on thin coronal DWI (83% sensitivity, 95% CI: 0.72-0.91). The difference in sensitivity was statistically significant (p = 0.0374). Lesions not visible on coronal DWI were 2-8 mm in size, the largest in the middle cerebellar peduncle.

conclusionsThin coronal DWI may not improve additional diagnostic utility beyond thin axial DWI for the detection of ischemia in patients with dizziness. When designing protocols tailored for stroke detection (particularly in the posterior circulation), replacing conventional (5 mm) DWI with thin (3 mm) axial DWI may be preferable to adding a thin coronal sequence.

Indexed as

Diffusion Magnetic Resonance ImagingDizzinessIschemic StrokeAgedAged, 80 and overEmergency Service, HospitalFemaleHumansMaleMiddle AgedRetrospective StudiesSensitivity and SpecificityAbbreviated MRIDizzinessDWIPosterior circulationStroke

Identifiers

PMID40053160

What OpenQuestion holds

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Registered trials

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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.