Diagnostic Value of Perfusion MR Imaging as a Potential Ancillary Test for Brain Death

Objective: The purpose of this study is to determine the potential role of dynamic susceptibility contrast (DSC) magnetic resonance (MR) perfusion imaging in diagnosing brain death. Materials and Methods: The study population was composed of 61 subjects (the Glasgow Coma Scale [GCS] score was 3 for all subjects), and 26 subjects were assigned to the control group (GCS scores between 4 and 6). At least four regions of interest (ROIs) from different anatomical regions were measured, the mean transit time (MTT), cerebral blood flow (CBF), and signal intensity time-to-course graphic were calculated. A second neurological examination (including an apnea test) was accepted as the gold standard method for the diagnosis of brain death. Results: DSC-MR perfusion imaging diagnosed brain death with a specificity of 100% (61/61) and a sensitivity of 86.8% (53/61). A cut-off value of maximum 3.5% decrease in the signal intensity time-to-course graphic was calculated by the Youden’s index and established for the to differentiate brain death from other conditions. Conclusion: DSC-MR perfusion imaging is a promising tool that may be used as a reliable add-on confirmatory diagnostic test for the brain death.