Cerebral infarctions: evaluation with single-axis versus trace diffusion-weighted MR imaging

OBJECTIVE: Our purpose was to determine the usefulness of single-axis diffusion-weighted imaging versus trace diffusion-weighted imaging in the evaluation of cerebral infarctions. SUBJECTS AND METHODS: Twenty-six patients harboring 34 infarctions were examined using single-axis and trace diffusion-weighted imaging within 48 hr of the onset of symptoms. Two neuroradiologists who were not aware of the clinical findings reviewed all images obtained with both techniques and noted the following: type of infarction (small [<15 mm] versus territorial), location of infarction, presence of infarction (seen only on single-axis images, seen only on trace images, seen on both), lesion conspicuity (better on single-axis images, better on trace images, or equal on both), and lesion size (larger on single-axis images, larger on trace images, or equal on both). Differences in opinion were resolved by consensus. RESULTS: Of the 18 small and 16 territorial infarctions, all were identified on both single-axis and trace imaging. Lesion conspicuity was judged to be slightly better on trace images for both types of infarctions. Lesion size was judged to be larger on single-axis images for territorial infarctions. CONCLUSION: Both single-axis and trace diffusion-weighted imaging showed all small and territorial cerebral infarctions. Both types of infarctions were slightly larger on single-axis images but this did not affect correct interpretation in any case. The single-axis technique provided sufficient information for the diagnosis of cerebral infarction in our clinical settings.