Radiology, Nuclear Medicine & Medical Imaging

Method: Since 2003 till the end of 2016 (13 years), we examined 220 ventilated patients in a deep coma with areflexia above C1. We performed 229 scintigraphy acquisitions to confirm brain death. Immediately after the intravenous administration of 99mTc-HMPAO there was performed dynamic scintigraphy, followed by static scintigraphy in the front, back and both side projections. Prior to administration of the radiopharmaceutical the radiochemical purity was always checked. All adult patients had during the application of the radiopharmaceutical mean arterial pressure more than 80 mmHg. Most frequent indication for this examination was to include the patient into the transplantation program; exceptionally brain death was diagnosed to stop the intensive care. Results: Majority of the patients were men (151, 69 %), less than a third were women (69, 31%). Patients had a mean age 43 years, the youngest patient was a 10-day newborn, the oldest was 68 years old. This examination was indicated in 25 children. The cause of coma and subsequent cerebral oedema was in 39 % trauma (traffic accidents, falls, suicide - jumping, gunshot wounds of the head), 61% were other causes - AV brain malformation, stroke, complications of epilepsy, complications of anticoagulation therapy, drowning, CO intoxication, brain tumours, abscesses, encephalitis, etc.). Investigations are evaluated qualitatively. Brain death was confirmed, if there was no accumulation of radiopharmaceuticals supra- and infratentorial. Brain death was detected in 207 patients (94 %), 13 patients at first examination had partially preserved brain perfusion. In the transplant program were enrolled 183 patients (83%), multiorgan harvesting was done in 80 patients (44 %), otherwise kidneys and heart were removed.