title: Emergency department experience of primary diffusion weighted magnetic resonance imaging for the patient with lacunar syndrome.
abstract: BACKGROUND
  The purpose of this study was to evaluate the usefulness of a particular magnetic resonance imaging technique known as primary diffusion weighted imaging (DWI) for patients with lacunar syndrome in the emergency department (ED).
  
  
  METHODS
  Patients with one of five classic lacunar syndromes underwent DWI as primary imaging modality. The DWI findings were classified into groups: (a) having a lesion with high signal intensity, (b) having a lesion with mixed signal intensity, and (c) unremarkable. The final clinical diagnoses were extracted from the patients' medical records, and used as a reference standard.
  
  
  RESULTS
  Of 151 DWI images, 120 (79%) were interpreted as high signal lesions, 21 (14%) as mixed signal lesions, and 10 (7%) as unremarkable. All patients with high signal lesions or unremarkable findings were diagnosed with ischaemic stroke. The patients with mixed signal lesions were diagnosed with haemorrhagic stroke with an exception of one ischaemic stroke.
  
  
  CONCLUSIONS
  Primary DWI is a feasible and useful neuroimaging tool for patients with lacunar syndrome in the ED.
authors.affiliation: Department of Emergency Medicine, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea Seoul, Republic of Korea. emstar@naver.com
authors.forename: S P
authors.initials: SP
authors.lastname: Chung
authors.forename: H S
authors.initials: HS
authors.lastname: Chung
authors.forename: S
authors.initials: S
authors.lastname: Ryu
authors.forename: S
authors.initials: S
authors.lastname: Rhu
authors.forename: S W
authors.initials: SW
authors.lastname: Kim
authors.forename: I S
authors.initials: IS
authors.lastname: Yoo
authors.forename: J
authors.initials: J
authors.lastname: Kim
authors.forename: C J
authors.initials: CJ
authors.lastname: Song
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020520:Brain Infarction / Q000175:diagnosis*; D038524:Diffusion Magnetic Resonance Imaging; D004635:Emergency Medicine / Q000379:methods; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity