6533b85dfe1ef96bd12be94c

RESEARCH PRODUCT

Implementation of computed tomography angiography (CTA) and computed tomography perfusion (CTP) in Polish guidelines for determination of cerebral circulatory arrest (CCA) during brain death/death by neurological criteria (BD/DNC) diagnosis procedure

Joanna PastuszkaJoanna WojczalKatarzyna Chamier-ciemińskaElżbieta JurkiewiczMarzena ZielińskaBohatyrewicz Romuald.Jerzy WaleckiPiotr LuchowskiWojciech PoncyljuszAndrzej PiotrowskiMarcin SawickiWojciech DabrowskiM ZukowskiWojciech WalasOlgierd RowińskiMarek MigdałMonika Bekiesińska-figatowskaMariusz PiechotaMaciej GuzińskiRadosław OwczukKrzysztof Kusza

subject

medicine.medical_specialtycerebral blood flowPerfusion scanningScintigraphyArticlemedicinebrain deathheterocyclic compoundscardiovascular diseasesCerebral perfusion pressureComputed tomography angiographymedicine.diagnostic_testbusiness.industrymusculoskeletal neural and ocular physiologydeath by neurologic criteriaRGeneral MedicineDigital subtraction angiographyTranscranial DopplerCerebral blood flowCT angiographyCirculatory systemCT perfusionMedicineRadiologybusinesspsychological phenomena and processes

description

Background: Brain death/death by neurologic criteria (BD/DNC) guidelines are routinely analyzed, compared and updated in the majority of countries and are later implemented as national criteria. At the same time, extensive works have been conducted in order to unify clinical procedures and to validate and implement new technologies into a panel of ancillary tests. Recently evaluated computed tomography angiography and computed tomography perfusion (CTA/CTP) seem to be superior to traditionally used digital subtraction angiography (DSA), transcranial Doppler (TCD) and cerebral perfusion scintigraphy for diagnosis of cerebral circulatory arrest (CCA). In this narrative review, we would like to demonstrate scientific evidence supporting the implementation of CTA/CTP in Polish guidelines for BD/DNC diagnosis. Research and implementation process: In the first of our base studies concerning the potential usefulness of CTA/CTP for the confirmation of CCA during BD/DNC diagnosis procedures, we showed a sensitivity of 96.3% of CTA in a group of 82 patients. CTA was validated against DSA in this report. In the second study, CTA showed a sensitivity of 86% and CTP showed a sensitivity of 100% in a group of 50 patients. In this study, CTA and CTP were validated against clinical diagnosis of BD/DNC supported by TCD. Additionally, we propose our CCA criteria for CTP test, which are based on ascertainment of cerebral blood flow (CBF) &lt

yearjournalcountryeditionlanguage
2021-09-01
https://www.mdpi.com/2077-0383/10/18/4237