title: Role of computed tomography angiography and perfusion tomography in diagnosing brain death: A systematic review.
abstract: 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.
authors.affiliation: University of São Paulo, School of Medicine, Hospital das Clínicas, Division of Neurological Surgery, São Paulo, Brazil. Electronic address: sbrasil@usp.br.
authors.forename: Sérgio
authors.initials: S
authors.lastname: Brasil
authors.affiliation: University of São Paulo, School of Medicine, Hospital das Clínicas, Division of Neurological Surgery, São Paulo, Brazil. Electronic address: edsonshu@hotmail.com.
authors.forename: Edson
authors.initials: E
authors.lastname: Bor-Seng-Shu
authors.affiliation: University of São Paulo, School of Medicine, Hospital das Clínicas, Division of Neurological Surgery, São Paulo, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: de-Lima-Oliveira
authors.affiliation: University of São Paulo, School of Medicine, Hospital das Clínicas, Division of Neurological Surgery, São Paulo, Brazil.
authors.forename: Milena
authors.initials: M
authors.lastname: K Azevedo
authors.affiliation: University of São Paulo, School of Medicine, Hospital das Clínicas, Division of Neurological Surgery, São Paulo, Brazil.
authors.forename: Manoel
authors.initials: M
authors.lastname: J Teixeira
authors.affiliation: University of São Paulo, School of Medicine, São Paulo, Brazil.
authors.forename: Luca
authors.initials: L
authors.lastname: Bernardo
authors.affiliation: University of São Paulo, School of Medicine, São Paulo, Brazil.
authors.forename: Wanderley
authors.initials: W
authors.lastname: M Bernardo
mesh_terms: D001926:Brain Death / Q000175:diagnosis*; D000072226:Computed Tomography Angiography / Q000379:methods*; D006801:Humans; D055420:Perfusion Imaging / Q000379:methods*; D014054:Tomography / Q000379:methods*
keywords: Angiography; Brain death; Computed perfusion tomography; Computed tomography angiography