title: Cerebral perfusion imaging with technetium-99m HM-PAO in brain death and severe central nervous system injury.
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 cerebellium 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.
authors: Department of Nuclear Medicine, Victoria Hospital, London, Ontario, Canada.
authors: N R
authors: NR
authors: Laurin
authors: A A
authors: AA
authors: Driedger
authors: G A
authors: GA
authors: Hurwitz
authors: A G
authors: AG
authors: Mattar
authors: J E
authors: JE
authors: Powe
authors: M J
authors: MJ
authors: Chamberlain
authors: P L
authors: PL
authors: Zabel
authors: W F
authors: WF
authors: Pavlosky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging; D001926:Brain Death / Q000000981:diagnostic imaging*; D001930:Brain Injuries / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010091:Oximes; D011875:Radionuclide Angiography; D012039:Regional Blood Flow; D012189:Retrospective Studies; D019690:Technetium Tc 99m Exametazime
chemical_list: D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime