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Updated: Jun 13, 2026
Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
Diffusion weighted imaging findings in the acute lateral medullary infarction
Min-Jung Seo1, Sook Young Roh, Yu-Suck Kyun
1Department of Neurology, Pundang Jesaeng General Hospital, Seongnam, Korea.
Background And Purpose:
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.
Insights
Early diffusion-weighted imaging (DWI) may miss acute lateral medullary infarction. A negative DWI result does not exclude this diagnosis, especially within 72 hours of symptom onset.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Diffusion-weighted imaging (DWI) is crucial for diagnosing brainstem infarction.
- Early medullary lesions on DWI can present as false negatives.
Purpose of the Study:
- To determine the false-negative rate of DWI in acute lateral medullary infarction.
- To evaluate factors influencing false-negative DWI results.
Main Methods:
- DWI was performed on 26 patients with suspected acute lateral medullary infarction within 72 hours of symptom onset.
- Analysis correlated initial DWI findings with time-to-MRI, clinical symptom count, and lesion volume.
Main Results:
- A 31% false-negative rate was observed in initial DWI scans.
- Increased time-to-MRI significantly reduced the false-negative rate (P=0.014).
- No significant correlation was found between false-negative rates and clinical symptom count or final lesion volume.
Conclusions:
- Early negative DWI results should not rule out lateral medullary infarction.
- Follow-up DWI or further MRI is recommended for suspected cases with initial negative DWI findings.
