Gadolinium-enhanced magnetic resonance angiography in brain death

Abstract

Confirmatory tests for the diagnosis of brain death in addition to clinical findings may shorten observation time required in some countries and may add certainty to the diagnosis under specific circumstances. The practicability of Gadolinium-enhanced magnetic resonance angiography to confirm cerebral circulatory arrest was assessed after the diagnosis of brain death in 15 patients using a 1.5 Tesla MRI scanner. In all 15 patients extracranial blood flow distal to the external carotid arteries was undisturbed. In 14 patients no contrast medium was noted within intracerebral vessels above the proximal level of the intracerebral arteries. In one patient more distal segments of the anterior and middle cerebral arteries (A3 and M3) were filled with contrast medium. Gadolinium-enhanced MRA may be considered conclusive evidence of cerebral circulatory arrest, when major intracranial vessels fail to fill with contrast medium while extracranial vessels show normal blood flow.

Portable Wideband Microwave Imaging System for Intracranial Hemorrhage Detection Using Improved Back-projection Algorithm with Model of Effective Head Permittivity

“…As the regular blood supply to the brain is interrupted, brain cells start dying while at the same time blood swelling elevates the intracranial pressure which compresses the adjacent tissues 1 . Since the ICH (traumatic and non-traumatic) can lead to brain deformation and a huge number of death (mortality rate of 30–50%) and disability (74% survivors) worldwide 2 3 4 , it is a crucial public health issue. On-the-spot accurate detection by means of head imaging is the governing factor of the timely medication to ensure complete recovery of the injured patient 4 5 .…”

Confirmation of brain death using optical methods based on tracking of an optical contrast agent: assessment of diagnostic feasibility

“…However, these parameters would place the tests used here alongside other currently investigated methods for brain death confirmation, i.e., computed tomography angiography (sensitivity, 63–87.5% 37 , 39 , 49 ; or diffusion-weighted magnetic resonance imaging (sensitivity 90%) 50 . Other methods that have higher sensitivity and specificity have limited accessibility (Xenon CT) 1 , are difficult to perform (magnetic resonance angiography) 51 , 52 or are operator-dependent (transcranial Doppler; sensitivity 88%, specificity 98%) 53 . We have shown that optical methods based on TR-NIRS are feasible during an ICU stay, available at the bedside, and have promising preliminary results.…”

Angiographische Verfahren zur Feststellung des zerebralen Zirkulationsstillstandes

“…veröffentlicht. 2014 publizierten Luchtmann et al[24] eine Studie mit Gd-unterstützter MRA. Probleme hinsichtlich des Einsatzes der MRA zur Feststellung des zerebralen Zirkulationsstilstandes ergeben sich je nach Hersteller aufgrund der sehr unterschiedlichen Sequenzparameter.…”