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Radiology, Vol 179, 95-99, Copyright © 1991 by Radiological Society of North America

ARTICLES

Assessment of brain death in children by means of P-31 MR spectroscopy: preliminary note. Work in progress

T Kato, A Tokumaru, T O'uchi, I Mikami, M Umeda, K Nose, T Eguchi, M Hasegawa and K Okuyama
Department of Pediatrics, Kameda General Hospital, Chiba, Japan.

The authors examined the possibility of assessing cerebral damage with phosphorus-31 magnetic resonance (MR) spectroscopy in 24 patients (three infants, four children older than age 5 years, and 17 adults) who met the adult criteria for brain death. In all patients except patient 3 (an infant 8 months old), inorganic phosphate with phosphodiester was observed, and adenosine triphosphate (ATP) and phosphocreatine (PCr), which are detectable in healthy brains, were not detected. In 22 of these 23 patients, cardiac death occurred within 7 days after clinical brain death, and in one infant 14 months old, cardiac death occurred 38 days after clinical brain death. In patient 3, ATP and PCr were detected with P-31 MR spectroscopy, and now, more than 20 months after brain death, cardiac death has not yet occurred. In children younger than age 5 years, P-31 MR spectroscopic findings were predictive of the patient's clinical outcome. These findings may help establish criteria for the diagnosis of brain death in children younger than age 5 years.


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Brief review: The role of ancillary tests in the neurological determination of death: [Revue sommaire : le role des tests accessoires dans la determination neurologique de la mort].
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[Abstract] [Full Text] [PDF]


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