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Published on: February 17, 2013
Diagnosing brain death by CT perfusion and multislice CT angiography
Dolores Escudero1, Jesús Otero, Lara Marqués
1Department of Intensive Care Medicine, Hospital Universitario Central de Asturias, C/Celestino Villamil s/n, 33006 Oviedo, Spain. dolores.escudero@sespa.princast.es
Neurocritical Care
|July 1, 2009
Summary
Cerebral multislice computed tomographic angiography (CTA) and CT perfusion (CTP) accurately diagnose brain death (BD) by detecting absent cerebral blood flow. This non-invasive imaging is a promising alternative to conventional angiography.
Area of Science:
- Neurology
- Radiology
- Critical Care Medicine
Background:
- Clinical diagnosis of brain death (BD) can be challenging in sedated patients.
- Ancillary techniques are crucial for confirming BD in challenging cases.
Purpose of the Study:
- To evaluate the accuracy of cerebral multislice computed tomographic angiography (CTA) and CT perfusion (CTP) in diagnosing BD.
- To assess the utility of CTA and CTP as diagnostic tools for cerebral circulatory arrest.
Main Methods:
- Prospective observational study involving 27 patients diagnosed with BD.
- Utilized 64-detector multislice CTA and CTP following clinical and electroencephalogram (EEG) confirmation of BD.
Main Results:
- CTP detected absent cerebral blood flow (CBF) in 24 patients.
- CTA showed internal carotid artery narrowing and absent intracranial circulation in 89% of patients.
- CTA identified extracranial CBF in internal carotid and vertebral arteries.
Conclusions:
- The combined CTA and CTP protocol demonstrates high sensitivity and specificity for detecting cerebral circulatory arrest in BD.
- This radiological approach is a viable, non-invasive alternative to conventional four-vessel angiography.
