RT Journal Article
SR Electronic
T1 Clinical Utility of Arterial Spin-Labeling as a Confirmatory Test for Suspected Brain Death
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A4209
A1 K.M. Kang
A1 T.J. Yun
A1 B.-W. Yoon
A1 B.S. Jeon
A1 S.H. Choi
A1 J.-h. Kim
A1 J.E. Kim
A1 C.-H. Sohn
A1 M.H. Han
YR 2015
UL http://www.ajnr.org/content/early/2015/01/08/ajnr.A4209.abstract
AB SUMMARY: Diagnosis of brain death is made on the basis of 3 essential findings: coma, absence of brain stem reflexes, and apnea. Although confirmatory tests are not mandatory in most situations, additional testing may be necessary to declare brain death in patients in whom results of specific components of clinical testing cannot be reliably evaluated. Recently, arterial spin-labeling has been incorporated as part of MR imaging to evaluate cerebral perfusion. Advantages of arterial spin-labeling include being completely noninvasive and providing information about absolute CBF. We retrospectively reviewed arterial spin-labeling findings according to the following modified criteria based on previously established confirmatory tests to determine brain death: 1) extremely decreased perfusion in the whole brain, 2) bright vessel signal intensity around the entry of the carotid artery to the skull, 3) patent external carotid circulation, and 4) “hollow skull sign” in a series of 5 patients. Arterial spin-labeling findings satisfied the criteria for brain death in all patients. Arterial spin-labeling imaging has the potential to be a completely noninvasive confirmatory test to provide additional information to assist in the diagnosis of brain death. Abbreviation ASLarterial spin-labeling