Paediatric brain death: Magnetic resonance angiography diagnostic criteria

Congress:

ECR 2018

Poster Number:

C-1193

Type:

Educational Exhibit

Keywords:

Oedema, Haemodynamics / Flow dynamics, Diagnostic procedure, MR-Angiography, Paediatric, Neuroradiology brain, CNS

Authors:

C. G. Iacoban, A. C. ANDREI, H. A. Alboi-Sandru; Cluj-Napoca/RO

DOI:

10.1594/ecr2018/C-1193

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-1193

Fig. 1: Brain death in a 3-month-old girl as a result of encephalomyelitis. A. T2...

Fig. 2: Brain death in a 22-month-old boy as a result of drowning. A. Sagittal FLAIR...

Fig. 3: Brain death in a 3 year old girl as a result of trauma. A. Note an incipient...

Findings and procedure details

MR angiographic examinations were performed on three clinically and EEG-proven brain-dead pediatric patients on a 1.5 Tesla Magnetom Avanto Siemens MR machine. T1-TRIM, T2-TSE, FLAIR, DWI (diffusion weighted imaging), SWI (susceptibility weighted imaging), 3D arterial TOF, Flash 3D ANGIO sequences where acquired for each individual in part before and after Gadolinium-based contrast administration.

Imaging findings included diffuse cerebral and cerebellar cytotoxic oedema with diffuse gyral swelling, tonsillar herniation, poor white-gray matter differentiation and arterial flow absence in the intracranial portion of the vertebral and internal carotid arteries forming the arterial circle of Willis. Axonal injuries and hemorrhagic post-traumatic lesions were also found in one case. Table I. Fig. 1 Fig. 2 Fig. 3

#	Age	Cause of brain death	MR Findings	MRA Findings
1.	3 months	Encephalomyelitis	Diffuse brain oedema	No intracranial flow
2.	22 months	Drowning	Diffuse brain oedema, tonsillar herniation	No intracranial flow
3.	3 years	Trauma	Diffuse brain oedema, tonsillar herniation, diffuse axonal injury	No intracranial flow

Table I. Brain death causes and MR/MRA findings in three paediatric patients.