计算机断层扫描血管造影和灌注断层扫描在诊断脑死亡中的作用：一项系统评价。
Role of computed tomography angiography and perfusion tomography in diagnosing brain death: A systematic review.
作者信息
Brasil Sérgio, Bor-Seng-Shu Edson, de-Lima-Oliveira Marcelo, K Azevedo Milena, J Teixeira Manoel, Bernardo Luca, M Bernardo Wanderley
机构信息
University of São Paulo, School of Medicine, Hospital das Clínicas, Division of Neurological Surgery, São Paulo, Brazil.
University of São Paulo, School of Medicine, Hospital das Clínicas, Division of Neurological Surgery, São Paulo, Brazil.
出版信息
J Neuroradiol. 2016 Mar;43(2):133-40. doi: 10.1016/j.neurad.2015.07.006. Epub 2015 Nov 2.
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.
背景
多种并发症使得脑死亡（BD）的医学诊断具有挑战性，因此需要一种辅助方法进行确诊。在此背景下，计算机断层血管造影（CTA）和计算机断层灌注成像（CTP）可能是有价值的替代方法；然而，CTA和CTP用于确认脑循环停止的可靠性仍不明确。
方法
进行了一项系统评价，以确定有关使用CTA和CTP作为辅助检查来确诊BD的相关研究。
结果
322例患者符合荟萃分析条件，其敏感性为87.5%。不同医疗机构之间，CTA图像评估方案在确定检测结果阳性或阴性时应考虑哪些颅内血管方面存在差异。
结论
对于先前根据临床标准诊断为BD的患者，CTA在提供放射学确诊方面表现出高敏感性。目前支持在BD诊断中使用CTA的证据与全球应用的其他方法相当。
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