CEREBRAL PERFUSION IMAGING WITH TECHNETIUM-99M HM-PAO IN BRAIN-DEATH AND SEVERE CENTRAL NERVOUS-SYSTEM INJURY

  • 1 October 1989
    • journal article
    • research article
    • Vol. 30  (10) , 1627-1635
Abstract
We performed 38 cerebral perfusion studies in 33 patients with brain death or with severe central nervous system injury using technetium-99m hexamethyl-propyleneamine oxime ([99mTc]HM-PAO). Uptake by the cerebrum and/or cerebellum was present in all patients who were not clinically brain dead (ten studies) although the study was often abnormal. In those patients who were brain dead, 16/17 studies demonstrated no uptake in either the cerebrum or cerebellum. In patients suspected of brain death, but who had conditions interfering with the diagnosis, the test demonstrated no uptake in 9/11 studies, confirming brain death. A radionuclide angiogram (RNA) of the head was also performed in 33/38 studies and showed complete agreement with the [99mTc]HM-PAO uptake, except in one case. We conclude that cerebral perfusion imaging with [99mTc]HM-PAO is a simple, noninvasive and reliable test to confirm brain death. By comparison with conventional technetium agents, [99mTc]HM-PAO is not dependent on the quality of the bolus injection, is easier to interpret and allows evaluation of posterior fossa blood flow.