Diffusion weighted imaging findings in the acute lateral medullary infarction.
OBJECTIVE
Negative findings on diffusion-weighted imaging (DWI) does not exclude the possibility of brainstem infarction, particularly in the acute stage of medullary lesion. Our aim was to investigate the false-negative rate of DWI in patients with acute lateral medullary infarction.


METHODS
We applied DWI to 26 patients with a clinical diagnosis of lateral medullary infarction within 72 h of the onset. We assessed relationships between initial DWI findings and time-to-MRI (the time between onset of symptoms and initial DWI), number of clinical symptoms and signs, and final lesion volume.


RESULTS
There were 8 cases (31%) of false negatives in the initial DWI results. The occurrence of false-negative DWI findings decreased significantly as the time-to-MRI increased (P=0.014). However, the false-negative rate was not significantly correlated with the number of clinical symptoms and signs or the final lesion volume.


CONCLUSIONS
The diagnosis of lateral medullary infarction should not be ruled out on the basis of early negative DWI. To confirm the lesion, follow-up DWI or further MRI should be performed in cases with early negative DWI results.
Seo
Min-Jung
MJ
Department of Neurology, Pundang Jesaeng General Hospital, Seongnam, Korea.
Roh
Sook Young
SY
Kyun
Yu-Suck
YS
Yu
Hyun-Jung
HJ
Cho
Young-Kuk
YK
AJNR Am J Neuroradiol. 1997 Sep;18(8):1435-45
9296184
J Neuroimaging. 2003 Apr;13(2):158-61
12722500
Acta Radiol. 2004 Feb;45(1):78-84
15164784
Brain. 2003 Aug;126(Pt 8):1864-72
12805095
Arch Neurol. 1993 Jun;50(6):609-14
8503798
AJNR Am J Neuroradiol. 1999 Nov-Dec;20(10):1876-80
10588112
AJNR Am J Neuroradiol. 1998 Jun-Jul;19(6):1061-6
9672012
Rinsho Shinkeigaku. 1998 Feb;38(2):157-60
9619082
AJNR Am J Neuroradiol. 2000 Sep;21(8):1434-40
11003275
Rev Neurol. 2002 Jun 16-30;34(12):1127-9
12134276
Stroke. 1973 Jul-Aug;4(4):674-83
4723697
Rinsho Shinkeigaku. 1999 May;39(5):573-6
10424153
No To Shinkei. 2001 Nov;53(11):1021-6
11761910
AJNR Am J Neuroradiol. 1998 Feb;19(2):201-8; discussion 209
9504466
Stroke. 1984 May-Jun;15(3):417-26
6729869