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Cerebral blood vessels and perfusion in the pediatric brain death: five cases studied by neuroimaging

  • Paediatric Neuroradiology
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Abstract

Purpose

To detect the cerebral blood vessels and perfusion using neuroimaging modalities including computed tomography angiography (CTA), computed tomography perfusion (CTP), and arterial spin labeling (ASL) in children with brain death (BD).

Methods

According to the current children’s BD criteria, 5 children (3 males, 2 females, mean age of 5.65 years) with BD were enrolled from January 2019 to December 2020. The imaging features of CTA, CTP, and ASL were evaluated to analyze the visualization of important intracranial blood vessels and the states of the cerebral blood flow (CBF) and cerebral blood volume (CBV) related to the region of interest (ROI) brain tissue during the two clinical assessments for BD.

Results

The “4-point scale” scoring system of CTA was applied to evaluate BD and no negative results were detected. The CTP results of the 5 children suggested the cessation of cerebral circulation with 100% positive results. The ranges of CBF and CBV were 0.00–9.52 ml/100 g/min (mean value 4.95 ± 1.69 ml/100 g/min) and 0.00–1.34 ml/100 g (mean value 0.36 ± 0.20 ml/100 g), respectively. One patient also underwent ASL examination, which demonstrated a significant reduction in whole brain perfusion, indicating the absence of cerebral circulation. The CBF values of the brainstem, basal ganglia, and prefrontal lobe were 11.61 ± 1.49 ml/100 g/min, 7.81 ± 2.42 ml/100 g/min, and 9.94 ± 2.01 ml/100 g/min, respectively.

Conclusion

Neuroimaging examinations particularly CTA and CTP reveal well the hemodynamic and cerebral blood vessels changes of BD, which can be used as supplementary supportive evidence for the declaration of brain death in children.

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Funding

No funding was received for this study.

Author information

Author notes

  1. Quan Wang, Tong Yu, Suyun Qian and Yun Peng contributed equally to this work.

Authors and Affiliations

  1. Emergency Department, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, No. 56, Nan-Li-Shi Road, Xicheng District, Beijing, 100045, China

    Quan Wang & Jie Wu

  2. Department of Radiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, No. 56, Nan-Li-Shi Road, Xicheng District, Beijing, 100045, China

    Tong Yu, Xiaojuan Tao, Huanyu Luo & Yun Peng

  3. Pediatric Intensive Care Unit, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, No. 56, Nan-Li-Shi Road, Xicheng District, Beijing, 100045, China

    Jun Liu, Hengmiao Gao & Suyun Qian

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  1. Quan Wang
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Corresponding authors

Correspondence to Suyun Qian or Yun Peng.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Wang, Q., Yu, T., Wu, J. et al. Cerebral blood vessels and perfusion in the pediatric brain death: five cases studied by neuroimaging. Neuroradiology 64, 1661–1669 (2022). https://doi.org/10.1007/s00234-022-02955-4

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  • DOI: https://doi.org/10.1007/s00234-022-02955-4

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