Morales-Ballesteros O, Pacheco-Hoyos N, Antillón-Valenzuela JE

Language: Spanish
References: 13
Page: 273-284
PDF size: 933.18 Kb.

ABSTRACT

We evaluated the usefulness of magnetic resonance studies, a littlestudied method for which there is no known precedent in Mexico, as support for the diagnosis of brain death. We conducted a transverse, descriptive, and comparative pilot study from September 2013 through July 2014 in patients at Hospital General del Estado de Sonora. Two groups were formed: group A, made up by eleven patients with clinical or paraclinical diagnosis (electroencephalogram) of brain death, and group B, made up by eleven patients without diagnosis of brain death. Then the findings in image studies were compared.
Results: tonsillar herniation, lack of arterial blood flow in 3D TOF (3D time of flight) (p ‹ 0.000), and bilateral signal from medullary and cortical veins in susceptibility weighted and gradient echo sequences (p ‹ 0.000) showed a strong relationship in patients with diagnosis of brain death. Findings in diffusion sequences did not show a significant relationship.
Conclusion: tonsillar herniation, absence of signal from intracranial arterial blood flow in 3D TOF, and bilateral signal from the cortical and medullary veins proved to be the most helpful data. We conclude that it is indispensable to use T2 SE and 3D TOF sequences, and optionally to use susceptibility weighted or gradient echo sequences in case of doubt; however, they may be dispensed with when it is imperative to reduce scanning time. The diffusion sequence was not found to be useful for these purposes.

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