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Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...

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False positive CT angiography in brain death.

David M Greer1, Dorothea Strozyk, Lee H Schwamm

  • 1Massachusetts General Hospital, ACC 739A, MGH, 55 Fruit Street, Boston, MA 02114, USA. dgreer@partners.org

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Computed tomographic angiography (CTA) may falsely indicate cerebral circulatory arrest in brain death determination. Further validation against gold standards like SPECT is crucial before CTA acceptance as a confirmatory test.

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Area of Science:

  • Neurology
  • Radiology
  • Forensic Medicine

Background:

  • Ancillary testing is vital for brain death determination when clinical exams are questionable.
  • Computed tomographic angiography (CTA) is a newer, easily performed test for assessing cerebral blood flow.

Observation:

  • A 31-year-old patient showed cerebral circulatory arrest on CTA.
  • However, transcranial Doppler revealed preserved cerebral blood flow in the same patient.

Findings:

  • CTA is not a validated confirmatory test for cerebral circulatory arrest.
  • CTA may produce false positive results in brain death diagnostics.

Implications:

  • CTA requires further comparative studies against gold standards like conventional angiography or SPECT.
  • Current validation status precludes CTA's acceptance as a standard ancillary test for brain death criteria.