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Role of computed tomography angiography and perfusion tomography in diagnosing brain death: A systematic review

Sérgio Brasil1, Edson Bor-Seng-Shu1, Marcelo de-Lima-Oliveira1

  • 1University of São Paulo, School of Medicine, Hospital das Clínicas, Division of Neurological Surgery, São Paulo, Brazil.

Journal of Neuroradiology = Journal De Neuroradiologie
|November 7, 2015
PubMed

Insights

Computed tomography angiography (CTA) offers reliable confirmation for brain death (BD) diagnosis. This method shows high sensitivity and is comparable to existing worldwide techniques for confirming circulatory arrest.

Area of Science:

  • Neurology
  • Radiology
  • Medical Diagnostics

Background:

  • Diagnosing brain death (BD) presents significant medical challenges.
  • There is a need for complementary diagnostic methods to confirm BD.
  • Computed tomography angiography (CTA) and computed tomography perfusion (CTP) are potential alternatives, but their reliability is uncertain.

Purpose of the Study:

  • To systematically review the literature on CTA and CTP for confirming brain circulatory arrest.
  • To evaluate the reliability of CTA and CTP as ancillary tests for brain death diagnosis.

Main Methods:

  • A systematic review methodology was employed.
  • Relevant studies investigating CTA and CTP for BD confirmation were identified.
  • A meta-analysis was conducted on eligible patient data.

Main Results:

  • The meta-analysis included 322 patients, demonstrating 87.5% sensitivity for CTA.
  • Variations in CTA image evaluation protocols were observed across institutions regarding intracranial vessel assessment.
  • CTA showed high sensitivity in confirming brain death.

Conclusions:

  • CTA provides reliable radiologic confirmation for patients diagnosed with BD via clinical criteria.
  • The evidence supporting CTA in brain death diagnosis is comparable to established global methods.
Abstract

Keywords:
AngiographyBrain deathComputed perfusion tomographyComputed tomography angiography

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