Brain Scintigraphy in Brain Death: the Experience of Nuclear Medicine Department in Dokuz Eylul University, School of Medicine

Abstract

We investigated the propriety between the findings of brain death scintigraphy and the patient outcomes after the scan. We figured out the benefits of scintigraphic findings to the diagnosis. This study was performed in our department between 2006-2011 and patients were evaluated retrospectively. Pre-diagnosis of brain death and final diagnosis were compared. 24 patients were referred to our nuclear medicine department between 2006-2011. All patients underwent brain scintigraphy following IV injection of 20 mCi of Tc 99m DTPA or 10 mCi Tc 99m HMPAO with one-second dynamic images in 128x128 matrix for a period of 60 seconds. Anterior, posterior, right and left lateral static images were obtained with 5-minute in 256x256 matrix after dynamic images. Patients were referred by the departments of internal medicine intensive care and anaesthesiology intensive care. No blood flow into the middle, anterior and posterior cerebral arteries and no activity in the venous sinuses were accepted as showing the brain death. 22 of 24 patients were reported that findings in brain scan were consistent with brain death as in the prediagnosis. Brain death was not reported in two patients with Tc-99m HMPAO scan and brain death was suspicious in one patient with Tc-99m DTPA scan. Two patients with Tc-99m HMPAO scan were died two weeks after the brain scan and the patient with Tc-99m DTPA was died one day after the brain scan. Brain scintigraphy is a non-invasive procedure supporting the clinical diagnosis and it can be also easily performed and can exclude the negative and suspicious patients. © 2014, Yuzuncu Yil Universitesi Tip Fakultesi, Universitas Indonesia. All rights reserved.