Reid R H, Gulenchyn K Y, Ballinger J R
Division of Nuclear Medicine, Ottawa Civic Hospital Ontario, Canada.
J Nucl Med. 1989 Oct;30(10):1621-6.
We report our clinical experience with the use of [99mTc]hexamethyl propyleneamine oxime (HM-PAO) in establishing a diagnosis of brain death in 11 patients following trauma to the head and four patients who suffered atraumatic injuries. In 9/15 studies there was no intracranial flow present and brain death was then confirmed by standard criteria. Of the remaining 6/15 studies which showed evidence of cerebral perfusion, 3/6 patients underwent a subsequent HM-PAO study which showed cessation of perfusion. One additional patient died of pneumonia and two patients survived. Thus, in all cases where there was no flow present the diagnosis of brain death was later confirmed whereas three patients clinically thought to be brain dead showed significant perfusion and survived the cerebral trauma. HM-PAO may be useful in determination of brain death because it provides unequivocal results, can be performed by planar imaging at the bedside, and does not require withdrawal of medical therapy, thus allowing a diagnosis to be established more rapidly.
我们报告了使用[99mTc]六甲基丙烯胺肟（HM-PAO）对11例头部创伤患者和4例非创伤性损伤患者进行脑死亡诊断的临床经验。在15项研究中的9项中，颅内无血流，随后通过标准标准确诊为脑死亡。其余6/15项显示有脑灌注证据的研究中，6例患者中有3例随后进行了HM-PAO研究，结果显示灌注停止。另有1例患者死于肺炎，2例患者存活。因此，在所有无血流的病例中，脑死亡诊断随后得到证实，而3例临床诊断为脑死亡的患者显示有明显灌注，并在脑外伤后存活。HM-PAO可能有助于确定脑死亡，因为它能提供明确的结果，可在床边通过平面成像进行，且无需停止医疗治疗，从而能更快地确立诊断。
