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Published on: November 20, 2015
Imaging findings of brain death on 3-tesla MRI
Chul-Ho Sohn1, Hwa-Pyung Lee, Jun Beom Park
1Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744, Korea.
Objective:
To demonstrate the usefulness of 3-tesla (3T) magnetic resonance imaging (MRI) including T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), time-of-flight (TOF) magnetic resonance angiography (MRA), T2*-weighted gradient recalled echo (GRE), and susceptibility weighted imaging (SWI) in diagnosing brain death.
Materials And Methods:
Magnetic resonance imaging findings for 10 patients with clinically verified brain death (group I) and seven patients with comatose or stuporous mentality who did not meet the clinical criteria of brain death (group II) were retrospectively reviewed.
Results:
Tonsilar herniation and loss of intraarterial flow signal voids (LIFSV) on T2WI were highly sensitive and specific findings for the diagnosis of brain death (p < 0.001 and < 0.001, respectively). DWI, TOF-MRA, and GRE findings were statistically different between the two groups (p = 0.015, 0.029, and 0.003, respectively). However, cortical high signal intensities in T2WI and SWI findings were not statistically different between the two group (p = 0.412 and 1.0, respectively).
Conclusion:
T2-weighted imaging, DWI, and MRA using 3T MRI may be useful for diagnosing brain death. However, SWI findings are not specific due to high false positive findings.
Insights
Three-tesla (3T) MRI, including T2-weighted imaging (T2WI) and diffusion weighted imaging (DWI), shows promise in diagnosing brain death. However, susceptibility weighted imaging (SWI) is not specific for this condition.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Diagnosing brain death requires accurate and reliable methods.
- Magnetic Resonance Imaging (MRI) offers advanced visualization of brain structures and functions.
- Evaluating the utility of various MRI sequences in confirming brain death is crucial.
Purpose of the Study:
- To assess the diagnostic value of 3-tesla (3T) MRI techniques for brain death.
- To compare MRI findings in patients with confirmed brain death versus those with severe neurological impairment.
Main Methods:
- Retrospective review of 3T MRI scans from 10 patients with brain death and 7 non-brain-dead patients.
- Analysis included T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), time-of-flight magnetic resonance angiography (TOF-MRA), T2*-weighted gradient recalled echo (GRE), and susceptibility weighted imaging (SWI).
Main Results:
- Tonsilar herniation and loss of intraarterial flow signal voids (LIFSV) on T2WI were highly sensitive and specific for brain death (p < 0.001).
- DWI, TOF-MRA, and GRE findings differed significantly between brain death and non-brain-death groups (p = 0.015, 0.029, 0.003).
- Cortical high signal intensities on T2WI and SWI findings were not statistically different between groups (p = 0.412, 1.0).
Conclusions:
- T2WI, DWI, and TOF-MRA using 3T MRI are potentially valuable tools for diagnosing brain death.
- SWI is not specific for brain death diagnosis due to a high rate of false positives.
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