DIAGNOSIS OF BRAIN-DEATH USING TC-99M-HMPAO SPECT, TC-99M-DTPA SCINTIGRAPHY AND RADIONUCLIDE ANGIOGRAPHY

Radionuclide cerebral angiography and static brain scintigraphy using 99mTc-DTPA were studied in patients with clinically suspected brain death. After twenty four hours, regional cerebral blood flow was evaluated using 99mTc-Hexamethylpropyleneamineoxime (HMPAO). Trasaxial, sagittal and coronal slices were generated. In 21 out of 23 patients, brain death was confirmed by using these above three methods together. Six patients showed neither cerebral nor cerebellar perfusion on the 99mTc-HMPAO/SPECT study, although they had exhibited either decreased blood flow with radionuclide cerebral angiography or sinus activity with static brain scintigraphy. In conclusion, the 99mTc-HMPAO/SPECT study was found to be more sensitive than radionuclide angiography and static brain scintigraphy as a means of diagnosing brain death and may be confirmatory if used in combination with the other two methods.