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Erschienen in: Neuroradiology 5/2012

01.05.2012 | Diagnostic Neuroradiology

CT and MR perfusion can discriminate severe cerebral hypoperfusion from perfusion absence: evaluation of different commercial software packages by using digital phantoms

verfasst von: Ikuko Uwano, Kohsuke Kudo, Makoto Sasaki, Soren Christensen, Leif Østergaard, Kuniaki Ogasawara, Akira Ogawa

Erschienen in: Neuroradiology | Ausgabe 5/2012

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Abstract

Introduction

Computed tomography perfusion (CTP) and magnetic resonance perfusion (MRP) are expected to be usable for ancillary tests of brain death by detection of complete absence of cerebral perfusion; however, the detection limit of hypoperfusion has not been determined. Hence, we examined whether commercial software can visualize very low cerebral blood flow (CBF) and cerebral blood volume (CBV) by creating and using digital phantoms.

Methods

Digital phantoms simulating 0–4% of normal CBF (60 mL/100 g/min) and CBV (4 mL/100 g/min) were analyzed by ten software packages of CT and MRI manufacturers. Region-of-interest measurements were performed to determine whether there was a significant difference between areas of 0% and areas of 1–4% of normal flow.

Results

The CTP software detected hypoperfusion down to 2–3% in CBF and 2% in CBV, while the MRP software detected that of 1–3% in CBF and 1–4% in CBV, although the lower limits varied among software packages.

Conclusion

CTP and MRP can detect the difference between profound hypoperfusion of <5% from that of 0% in digital phantoms, suggesting their potential efficacy for assessing brain death.
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Literatur
1.
Zurück zum Zitat Wijdicks EF (2002) Brain death worldwide: accepted fact but no global consensus in diagnostic criteria. Neurology 58(1):20–25PubMed Wijdicks EF (2002) Brain death worldwide: accepted fact but no global consensus in diagnostic criteria. Neurology 58(1):20–25PubMed
2.
Zurück zum Zitat Young GB, Lee D (2004) A critique of ancillary tests for brain death. Neurocrit Care 1(4):499–508PubMedCrossRef Young GB, Lee D (2004) A critique of ancillary tests for brain death. Neurocrit Care 1(4):499–508PubMedCrossRef
3.
Zurück zum Zitat Busl KM, Greer DM (2009) Pitfalls in the diagnosis of brain death. Neurocrit Care 11(2):276–287PubMedCrossRef Busl KM, Greer DM (2009) Pitfalls in the diagnosis of brain death. Neurocrit Care 11(2):276–287PubMedCrossRef
4.
Zurück zum Zitat Heran MK, Heran NS, Shemie SD (2008) A review of ancillary tests in evaluating brain death. Can J Neurol Sci 35(4):409–419PubMed Heran MK, Heran NS, Shemie SD (2008) A review of ancillary tests in evaluating brain death. Can J Neurol Sci 35(4):409–419PubMed
5.
Zurück zum Zitat Dupas B, Gayet-Delacroix M, Villers D, Antonioli D, Veccherini MF, Soulillou JP (1998) Diagnosis of brain death using two-phase spiral CT. AJNR Am J Neuroradiol 19(4):641–647PubMed Dupas B, Gayet-Delacroix M, Villers D, Antonioli D, Veccherini MF, Soulillou JP (1998) Diagnosis of brain death using two-phase spiral CT. AJNR Am J Neuroradiol 19(4):641–647PubMed
6.
Zurück zum Zitat Frampas E, Videcoq M, de Kerviler E, Ricolfi F, Kuoch V, Mourey F, Tenaillon A, Dupas B (2009) CT angiography for brain death diagnosis. AJNR Am J Neuroradiol 30(8):1566–1570PubMedCrossRef Frampas E, Videcoq M, de Kerviler E, Ricolfi F, Kuoch V, Mourey F, Tenaillon A, Dupas B (2009) CT angiography for brain death diagnosis. AJNR Am J Neuroradiol 30(8):1566–1570PubMedCrossRef
7.
Zurück zum Zitat Karantanas AH, Hadjigeorgiou GM, Paterakis K, Sfiras D, Komnos A (2002) Contribution of MRI and MR angiography in early diagnosis of brain death. Eur Radiol 12(11):2710–2716PubMed Karantanas AH, Hadjigeorgiou GM, Paterakis K, Sfiras D, Komnos A (2002) Contribution of MRI and MR angiography in early diagnosis of brain death. Eur Radiol 12(11):2710–2716PubMed
8.
Zurück zum Zitat Ostergaard L, Weisskoff RM, Chesler DA, Gyldensted C, Rosen BR (1996) High resolution measurement of cerebral blood flow using intravascular tracer bolus passages. Part I: mathematical approach and statistical analysis. Magn Reson Med 36(5):715–725PubMedCrossRef Ostergaard L, Weisskoff RM, Chesler DA, Gyldensted C, Rosen BR (1996) High resolution measurement of cerebral blood flow using intravascular tracer bolus passages. Part I: mathematical approach and statistical analysis. Magn Reson Med 36(5):715–725PubMedCrossRef
9.
Zurück zum Zitat Meier P, Zierler KL (1954) On the theory of the indicator-dilution method for measurement of blood flow and volume. J Appl Physiol 6(12):731–744PubMed Meier P, Zierler KL (1954) On the theory of the indicator-dilution method for measurement of blood flow and volume. J Appl Physiol 6(12):731–744PubMed
10.
Zurück zum Zitat Stewart GN (1893) Researches on the circulation time in organs and on the influences which affect it: Parts I–III. J Physiol 15(1–2):1–89PubMed Stewart GN (1893) Researches on the circulation time in organs and on the influences which affect it: Parts I–III. J Physiol 15(1–2):1–89PubMed
11.
Zurück zum Zitat Wu O, Ostergaard L, Weisskoff RM, Benner T, Rosen BR, Sorensen AG (2003) Tracer arrival timing-insensitive technique for estimating flow in MR perfusion-weighted imaging using singular value decomposition with a block-circulant deconvolution matrix. Magn Reson Med 50(1):164–174PubMedCrossRef Wu O, Ostergaard L, Weisskoff RM, Benner T, Rosen BR, Sorensen AG (2003) Tracer arrival timing-insensitive technique for estimating flow in MR perfusion-weighted imaging using singular value decomposition with a block-circulant deconvolution matrix. Magn Reson Med 50(1):164–174PubMedCrossRef
12.
Zurück zum Zitat Latchaw RE, Yonas H, Hunter GJ, Yuh WT, Ueda T, Sorensen AG, Sunshine JL, Biller J, Wechsler L, Higashida R, Hademenos G (2003) Guidelines and recommendations for perfusion imaging in cerebral ischemia: a scientific statement for healthcare professionals by the writing group on perfusion imaging, from the Council on Cardiovascular Radiology of the American Heart Association. Stroke 34(4):1084–1104PubMedCrossRef Latchaw RE, Yonas H, Hunter GJ, Yuh WT, Ueda T, Sorensen AG, Sunshine JL, Biller J, Wechsler L, Higashida R, Hademenos G (2003) Guidelines and recommendations for perfusion imaging in cerebral ischemia: a scientific statement for healthcare professionals by the writing group on perfusion imaging, from the Council on Cardiovascular Radiology of the American Heart Association. Stroke 34(4):1084–1104PubMedCrossRef
13.
Zurück zum Zitat Jones TH, Morawetz RB, Crowell RM, Marcoux FW, FitzGibbon SJ, DeGirolami U, Ojemann RG (1981) Thresholds of focal cerebral ischemia in awake monkeys. J Neurosurg 54(6):773–782PubMedCrossRef Jones TH, Morawetz RB, Crowell RM, Marcoux FW, FitzGibbon SJ, DeGirolami U, Ojemann RG (1981) Thresholds of focal cerebral ischemia in awake monkeys. J Neurosurg 54(6):773–782PubMedCrossRef
14.
Zurück zum Zitat Pistoia F, Johnson DW, Darby JM, Horton JA, Applegate LJ, Yonas H (1991) The role of xenon CT measurements of cerebral blood flow in the clinical determination of brain death. AJNR Am J Neuroradiol 12(1):97–103PubMed Pistoia F, Johnson DW, Darby JM, Horton JA, Applegate LJ, Yonas H (1991) The role of xenon CT measurements of cerebral blood flow in the clinical determination of brain death. AJNR Am J Neuroradiol 12(1):97–103PubMed
15.
Zurück zum Zitat Darby JM, Yonas H, Gur D, Latchaw RE (1987) Xenon-enhanced computed tomography in brain death. Arch Neurol 44(5):551–554PubMedCrossRef Darby JM, Yonas H, Gur D, Latchaw RE (1987) Xenon-enhanced computed tomography in brain death. Arch Neurol 44(5):551–554PubMedCrossRef
16.
Zurück zum Zitat Donohoe KJ, Frey KA, Gerbaudo VH, Mariani G, Nagel JS, Shulkin B (2003) Procedure guideline for brain death scintigraphy. J Nucl Med 44(5):846–851PubMed Donohoe KJ, Frey KA, Gerbaudo VH, Mariani G, Nagel JS, Shulkin B (2003) Procedure guideline for brain death scintigraphy. J Nucl Med 44(5):846–851PubMed
17.
Zurück zum Zitat Munari M, Zucchetta P, Carollo C, Gallo F, De Nardin M, Marzola MC, Ferretti S, Facco E (2005) Confirmatory tests in the diagnosis of brain death: comparison between SPECT and contrast angiography. Crit Care Med 33(9):2068–2073PubMedCrossRef Munari M, Zucchetta P, Carollo C, Gallo F, De Nardin M, Marzola MC, Ferretti S, Facco E (2005) Confirmatory tests in the diagnosis of brain death: comparison between SPECT and contrast angiography. Crit Care Med 33(9):2068–2073PubMedCrossRef
18.
Zurück zum Zitat Wijdicks EF (2010) The case against confirmatory tests for determining brain death in adults. Neurology 75(1):77–83PubMedCrossRef Wijdicks EF (2010) The case against confirmatory tests for determining brain death in adults. Neurology 75(1):77–83PubMedCrossRef
19.
Zurück zum Zitat Ishii K, Onuma T, Kinoshita T, Shiina G, Kameyama M, Shimosegawa Y (1996) Brain death: MR and MR angiography. AJNR Am J Neuroradiol 17(4):731–735PubMed Ishii K, Onuma T, Kinoshita T, Shiina G, Kameyama M, Shimosegawa Y (1996) Brain death: MR and MR angiography. AJNR Am J Neuroradiol 17(4):731–735PubMed
20.
Zurück zum Zitat Escudero D, Otero J, Marques L, Parra D, Gonzalo JA, Albaiceta GM, Cofino L, Blanco A, Vega P, Murias E, Meilan A, Roger RL, Taboada F (2009) Diagnosing brain death by CT perfusion and multislice CT angiography. Neurocrit Care 11(2):261–271PubMedCrossRef Escudero D, Otero J, Marques L, Parra D, Gonzalo JA, Albaiceta GM, Cofino L, Blanco A, Vega P, Murias E, Meilan A, Roger RL, Taboada F (2009) Diagnosing brain death by CT perfusion and multislice CT angiography. Neurocrit Care 11(2):261–271PubMedCrossRef
21.
Zurück zum Zitat Salomon EJ, Barfett J, Willems PW, Geibprasert S, Bacigaluppi S, Krings T (2009) Dynamic CT angiography and CT perfusion employing a 320-detector row CT: protocol and current clinical applications. Klin Neuroradiol 19(3):187–196PubMedCrossRef Salomon EJ, Barfett J, Willems PW, Geibprasert S, Bacigaluppi S, Krings T (2009) Dynamic CT angiography and CT perfusion employing a 320-detector row CT: protocol and current clinical applications. Klin Neuroradiol 19(3):187–196PubMedCrossRef
22.
Zurück zum Zitat Murayama K, Katada K, Nakane M, Toyama H, Anno H, Hayakawa M, Ruiz DS, Murphy KJ (2009) Whole-brain perfusion CT performed with a prototype 256-detector row CT system: initial experience. Radiology 250(1):202–211PubMedCrossRef Murayama K, Katada K, Nakane M, Toyama H, Anno H, Hayakawa M, Ruiz DS, Murphy KJ (2009) Whole-brain perfusion CT performed with a prototype 256-detector row CT system: initial experience. Radiology 250(1):202–211PubMedCrossRef
23.
Zurück zum Zitat Ulzheimer S, Flohr T (2009) Multislice CT: current technology and future developments. In: Reiser MF, Becker CR, Nikolaou K, Glazer G (eds) Multislice CT. Medical radiology. Springer, Berlin Heidelberg, pp 3–23CrossRef Ulzheimer S, Flohr T (2009) Multislice CT: current technology and future developments. In: Reiser MF, Becker CR, Nikolaou K, Glazer G (eds) Multislice CT. Medical radiology. Springer, Berlin Heidelberg, pp 3–23CrossRef
24.
Zurück zum Zitat Stocchetti N, Zanier ER, Nicolini R, Faegersten E, Canavesi K, Conte V, Gattinoni L (2005) Oxygen and carbon dioxide in the cerebral circulation during progression to brain death. Anesthesiology 103(5):957–961PubMedCrossRef Stocchetti N, Zanier ER, Nicolini R, Faegersten E, Canavesi K, Conte V, Gattinoni L (2005) Oxygen and carbon dioxide in the cerebral circulation during progression to brain death. Anesthesiology 103(5):957–961PubMedCrossRef
25.
Zurück zum Zitat Bohatyrewicz R, Sawicki M, Walecka A, Walecki J, Rowinski O, Bohatyrewicz A, Kanski A, Czajkowski Z, Krzysztalowski A, Solek-Pastuszka J, Zukowski M, Marzec-Lewenstein E, Wojtaszek M (2010) Computed tomographic angiography and perfusion in the diagnosis of brain death. Transplant Proc 42(10):3941–3946PubMedCrossRef Bohatyrewicz R, Sawicki M, Walecka A, Walecki J, Rowinski O, Bohatyrewicz A, Kanski A, Czajkowski Z, Krzysztalowski A, Solek-Pastuszka J, Zukowski M, Marzec-Lewenstein E, Wojtaszek M (2010) Computed tomographic angiography and perfusion in the diagnosis of brain death. Transplant Proc 42(10):3941–3946PubMedCrossRef
26.
Zurück zum Zitat Nabavi DG, Cenic A, Craen RA, Gelb AW, Bennett JD, Kozak R, Lee TY (1999) CT assessment of cerebral perfusion: experimental validation and initial clinical experience. Radiology 213(1):141–149PubMed Nabavi DG, Cenic A, Craen RA, Gelb AW, Bennett JD, Kozak R, Lee TY (1999) CT assessment of cerebral perfusion: experimental validation and initial clinical experience. Radiology 213(1):141–149PubMed
Metadaten
Titel
CT and MR perfusion can discriminate severe cerebral hypoperfusion from perfusion absence: evaluation of different commercial software packages by using digital phantoms
verfasst von
Ikuko Uwano
Kohsuke Kudo
Makoto Sasaki
Soren Christensen
Leif Østergaard
Kuniaki Ogasawara
Akira Ogawa
Publikationsdatum
01.05.2012
Verlag
Springer-Verlag
Erschienen in
Neuroradiology / Ausgabe 5/2012
Print ISSN: 0028-3940
Elektronische ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-011-0905-8

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