RT Journal Article
SR Electronic
T1 Diagnosis of brain death using two-phase spiral CT.
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 641
OP 647
VO 19
IS 4
A1 B Dupas
A1 M Gayet-Delacroix
A1 D Villers
A1 D Antonioli
A1 M F Veccherini
A1 J P Soulillou
YR 1998
UL http://www.ajnr.org/content/19/4/641.abstract
AB PURPOSE The purpose of this study was to determine the utility of spiral CT in the diagnosis of brain death.METHODS Spiral CT was evaluated prospectively in 14 brain-dead patients and in 11 healthy subjects. A two-phase protocol was used. Twenty seconds after intravenous injection of a nonionic iodinized contrast medium, the CT table was drawn through the gantry at a rate of 10 mm/s while scanning was in progress. The second scanning phase was started automatically a mean of 54 seconds later, using the same parameters. Opacification or absence of opacification of carotid, vertebral, and basilar arteries and intracerebral veins was ascertained for each image in both phases. The diagnosis of brain death was confirmed by elecroencephalography (n = 7), angiography (n = 5), or both (n = 2). Statistical analysis with the Fisher exact test enabled us to compare the brain-dead patients with the healthy control subjects.RESULTS In brain death, the pericallosal and terminal arteries of the cortex did not opacify during the two phases of spiral CT, whereas the superficial temporal arteries were always visible. The internal cerebral veins, the great cerebral vein, and the straight sinus did not opacify, whereas the superior ophthalmic veins were visible on both sides 13 times. For each vessel type, specificity was 100% for nonvascular opacification criteria on the right and left sides.CONCLUSION Two-phase spiral CT can demonstrate the absence of intracerebral blood flow in brain death.