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Clin Nucl Med. 1993 May;18(5):428-34.

The diagnosis of brain death with Tc-99m HMPAO.

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Department of Radiology, Medical University of South Carolina, Charleston 29425.


Evaluation of blood flow to the brain using various radiopharmaceuticals can be used to confirm brain death. Agents available for this purpose include Tc-99m HMPAO, Tc-99m pertechnetate, Tc-99m glucoheptonate, and Tc-99m DTPA. The authors evaluated the use of Tc-99m HMPAO in 17 patients suspected of brain death using flow images and static images at several time intervals: immediately, between 30 and 60 minutes, and at 2 hours. These studies were compared to several studies performed with Tc-99m glucoheptonate and Tc-99m DTPA. The results of the Tc-99m HMPAO brain death studies correlated well with the patients' clinical conditions. Static images 1 to 2 hours after the injection of 5 to 30 mCi of Tc-99m HMPAO were satisfactory for an accurate interpretation; however, an immediate answer could as easily be supplied using flow images alone. Tc-99m HMPAO was found to be more easily interpreted and less dependent on imaging technique than Tc-99m glucoheptonate and Tc-99m DTPA, and it is the agent of choice for the evaluation of brain death.

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