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Published on: December 30, 2015
Magnetic resonance imaging of brain death
D H Lee1, J A Nathanson, A J Fox
1Department of Diagnostic Radiology and Nuclear Medicine, University Hospital, London, Ont.
Objective:
To demonstrate the magnetic resonance imaging (MRI) appearance of the brain in patients with clinical brain death.
Patients And Methods:
High-field (1.5-T) MRI was performed on five patients who were subsequently proven clinically brain dead. Conventional T1-weighted and T2-weighted imaging was performed.
Results:
MRI exhibited similar features for all of the patients: loss of the subarachnoid spaces of the brain; slow flow in the intracavernous and cervical internal carotid arteries; and loss of flow void in the small and large intracranial arteries, as well as in the major intracranial venous sinuses. The differentiation between grey and white matter in the brain was preserved, although the brain had a "supernormal" appearance due to the absence of cerebrospinal fluid and arterial pulsations. These findings have not been observed in MRI of comatose patients who were not clinically brain dead.
Conclusion:
With the advent of MRI-compatible ventilators and noninvasive monitoring, which facilitate imaging of patients under intensive care, MRI may offer another method of confirming the clinical diagnosis of brain death.
Insights
Magnetic resonance imaging (MRI) reveals distinct brain changes in patients with clinical brain death, including loss of subarachnoid spaces and altered blood flow. These MRI findings may aid in confirming brain death diagnosis.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Clinical brain death diagnosis relies on neurological criteria.
- Advanced neuroimaging techniques are being explored to supplement clinical assessments.
Purpose of the Study:
- To illustrate the characteristic magnetic resonance imaging (MRI) findings in the brains of individuals diagnosed with clinical brain death.
Main Methods:
- High-field (1.5-T) MRI was conducted on five patients diagnosed with clinical brain death.
- Conventional T1-weighted and T2-weighted imaging sequences were utilized.
Main Results:
- Consistent MRI findings across all patients included loss of subarachnoid spaces and altered cerebral blood flow.
- Absence of flow void in intracranial arteries and venous sinuses was observed.
- Preserved grey-white matter differentiation and a "supernormal" brain appearance were noted, differentiating from comatose patients.
Conclusions:
- MRI demonstrates unique brain imaging features in clinical brain death.
- With advancements in MRI technology for intensive care units, MRI may serve as an additional tool for confirming brain death.
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