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Ultrasonographic Cerebral Perfusion in Assessment of Brain Death

A Preliminary Study

Servicio de Medicina Intensiva (J.M.A., J.A.L.-P., J.H., J.V., J.I., J.P.-B.) and Coordinación Hospitalaria de Transplantes (J.H., J.V., J.P.-B.), Hospital Universitario Son Dureta, Palma de Mallorca, Illes Balears, Spain.

Address correspondence to Juan A. Llompart-Pou, MD, Servicio de Medicina Intensiva, Hospital Universitario Son Dureta, c/ Andrea Doria 55, 07014 Palma de Mallorca, Illes Balears, Spain. E-mail: jallompart{at}hsd.es

Objective. The purpose of this series was to describe the ultrasonographic perfusion pattern in patients with brain death. Methods. Thirteen patients with different neurologic disorders in whom brain death developed were studied. Transcranial perfusion was analyzed after injection of 2.5 mL of a sulfur hexafluoride ultrasonographic contrast agent. Time-intensity curves were analyzed in predetermined regions of interest. Results. In all patients, analysis of regions of interest showed no bolus-like curve progression. This finding implies a complete absence of cerebral perfusion. Conclusions. Patients with brain death studied by ultrasonographic perfusion techniques have a characteristic pattern.

Key Words: brain death • cerebral perfusion • time-intensity curves • ultrasonographic contrast agent • ultrasonographic perfusion imaging

Abbreviations: ROI, region of interest • TIC, time-intensity curve • UCA, ultrasonographic contrast agent • UPI, ultrasonographic perfusion imaging