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

• Published in: Journal of neuroradiology Vol. 43; no. 2; pp. 133 - 140
• Main Authors: Brasil, Sérgio, Bor-Seng-Shu, Edson, de-Lima-Oliveira, Marcelo, K. Azevedo, Milena, J. Teixeira, Manoel, Bernardo, Luca, M. Bernardo, Wanderley
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01-03-2016
• Subjects: Angiography; Brain death; Brain Death - diagnosis; Computed perfusion tomography; Computed tomography angiography; Computed Tomography Angiography - methods; Humans; Perfusion Imaging - methods; Radiology; Tomography - methods; BD; Angiography; EEG; Brain death; digital subtraction angiography; CNS; Computed perfusion tomography; electroencephalogram; central nervous system; Computed tomography angiography; internal cerebral vein; transcranial Doppler; DSA; TCD; ICV
• ISSN: 0150-9861
• DOI: 10.1016/j.neurad.2015.07.006

Summary Background Several complications make the diagnosis of brain death (BD) medically challenging and a complimentary method is needed for confirmation. In this context, computed tomography angiography (CTA) and computed tomography perfusion (CTP) could represent valuable alternatives; however, the reliability of CTA and CTP for confirming brain circulatory arrest remains unclear. Methods A systematic review was performed to identify relevant studies regarding the use of CTA and CTP as ancillary tests for BD confirmation. Results Three hundred twenty-two patients were eligible for the meta-analysis, which exhibited 87.5% sensitivity. CTA image evaluation protocol exhibited variations between medical institutions regarding which intracranial vessels should be considered to determine positive or negative test results. Conclusions For patients who were previously diagnosed with BD according to clinical criteria, CTA demonstrated high sensitivity to provide radiologic confirmation. The current evidence that supports the use of CTA in BD diagnosis is comparable to other methods applied worldwide.