Utility of brain parenchyma density measurement and computed tomography perfusion imaging in predicting brain death

2020
journal article
article
cris.lastimport.wos2024-04-09T21:31:54Z
dc.abstract.enPurpose: To assess the utility of brain parenchyma density measurement on unenhanced computed tomography (CT) in predicting brain death (BD), in order to evaluate the added value of CT perfusion (CTP). Material and methods: A total of 77 patients who were clinically diagnosed as BD and had both CT angiography (CTA) and CTP imaging in the same session were retrospectively reviewed. On unenhanced phase of CTA, density measurement was performed from 23 regions of interests (ROIs) which were located in the following areas: level of basal ganglia (caudate nucleus, putamen, corpus callosum, posterior limb of internal capsule), level of brainstem, greywhite matters on levels of centrum semiovale (CS), high convexity (HC), and cerebellum. CTP images were evaluated qualitatively and independently. Grey matter (GM), white matter (WM), density, and GM/WM density ratio of BD patients were compared with control subjects. Results: Comparing with the normal control group, the GM and WM density at each level and GM/WM density ratio of CS, HC, and cerebellum level were significantly lower in brain-dead patients (p = 0.019 for HC-WM, p < 0.001 for other areas). Using ROC analysis, the highest value of area under curve (AUC) for the GM/WM density ratio was found at the HC level (AUC = 0.907). The sensitivity of the GM/WM density ratio at the HC level was found to be 90% when the cut-off value of 1.25 was identified. Evaluating the GM/WM density ratio together with the CTP results increased the sensitivity further to 98%. Conclusions: The GM/WM density ratio at the HC level on unenhanced CT may be a useful finding to predict BD. Also, the addition of CTP increases the sensitivity of this method.pl
dc.contributor.authorAkdogan, Asli I.pl
dc.contributor.authorSahin, Hilalpl
dc.contributor.authorPekcevik, Yelizpl
dc.contributor.authorUluer, Haticepl
dc.date.accessioned2020-12-30T17:08:20Z
dc.date.available2020-12-30T17:08:20Z
dc.date.issued2020pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.additionalBibliogr. s. e642pl
dc.description.physicale636-e642pl
dc.description.versionostateczna wersja wydawcy
dc.description.volume85pl
dc.identifier.doi10.5114/pjr.2020.101482pl
dc.identifier.eissn1899-0967pl
dc.identifier.issn1733-134Xpl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/259517
dc.languageengpl
dc.language.containerengpl
dc.rightsUdzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 4.0 Międzynarodowa*
dc.rights.licenceCC-BY-NC-ND
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/legalcode.pl*
dc.share.typeotwarte czasopismo
dc.subject.enbrain deathpl
dc.subject.encomputed tomography angiographypl
dc.subject.encomputed tomography perfusionpl
dc.subject.endensitypl
dc.subtypeArticlepl
dc.titleUtility of brain parenchyma density measurement and computed tomography perfusion imaging in predicting brain deathpl
dc.title.journalPolish Journal of Radiologypl
dc.typeJournalArticlepl
dspace.entity.typePublication
cris.lastimport.wos
2024-04-09T21:31:54Z
dc.abstract.enpl
Purpose: To assess the utility of brain parenchyma density measurement on unenhanced computed tomography (CT) in predicting brain death (BD), in order to evaluate the added value of CT perfusion (CTP). Material and methods: A total of 77 patients who were clinically diagnosed as BD and had both CT angiography (CTA) and CTP imaging in the same session were retrospectively reviewed. On unenhanced phase of CTA, density measurement was performed from 23 regions of interests (ROIs) which were located in the following areas: level of basal ganglia (caudate nucleus, putamen, corpus callosum, posterior limb of internal capsule), level of brainstem, greywhite matters on levels of centrum semiovale (CS), high convexity (HC), and cerebellum. CTP images were evaluated qualitatively and independently. Grey matter (GM), white matter (WM), density, and GM/WM density ratio of BD patients were compared with control subjects. Results: Comparing with the normal control group, the GM and WM density at each level and GM/WM density ratio of CS, HC, and cerebellum level were significantly lower in brain-dead patients (p = 0.019 for HC-WM, p < 0.001 for other areas). Using ROC analysis, the highest value of area under curve (AUC) for the GM/WM density ratio was found at the HC level (AUC = 0.907). The sensitivity of the GM/WM density ratio at the HC level was found to be 90% when the cut-off value of 1.25 was identified. Evaluating the GM/WM density ratio together with the CTP results increased the sensitivity further to 98%. Conclusions: The GM/WM density ratio at the HC level on unenhanced CT may be a useful finding to predict BD. Also, the addition of CTP increases the sensitivity of this method.
dc.contributor.authorpl
Akdogan, Asli I.
dc.contributor.authorpl
Sahin, Hilal
dc.contributor.authorpl
Pekcevik, Yeliz
dc.contributor.authorpl
Uluer, Hatice
dc.date.accessioned
2020-12-30T17:08:20Z
dc.date.available
2020-12-30T17:08:20Z
dc.date.issuedpl
2020
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.additionalpl
Bibliogr. s. e642
dc.description.physicalpl
e636-e642
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
85
dc.identifier.doipl
10.5114/pjr.2020.101482
dc.identifier.eissnpl
1899-0967
dc.identifier.issnpl
1733-134X
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/259517
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights*
Udzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 4.0 Międzynarodowa
dc.rights.licence
CC-BY-NC-ND
dc.rights.uri*
http://creativecommons.org/licenses/by-nc-nd/4.0/legalcode.pl
dc.share.type
otwarte czasopismo
dc.subject.enpl
brain death
dc.subject.enpl
computed tomography angiography
dc.subject.enpl
computed tomography perfusion
dc.subject.enpl
density
dc.subtypepl
Article
dc.titlepl
Utility of brain parenchyma density measurement and computed tomography perfusion imaging in predicting brain death
dc.title.journalpl
Polish Journal of Radiology
dc.typepl
JournalArticle
dspace.entity.type
Publication

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