Computed Tomography Angiography (CTA) in Selected Scenarios with Risk of Possible False-Positive or False-Negative Conclusions in Diagnosing Brain Death
It is widely accepted that brain death (BD) is a diagnosis based on clinical examination. However, false-positive and false-negative evaluation results may be serious limitations. Ancillary tests are used when there is uncertainty about the reliability of the neurologic examination. Computed tomogra...
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MDPI AG
2022-10-01
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| Online Access: | https://www.mdpi.com/2075-1729/12/10/1551 |
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| author | Gerhard Schwarz Maximilian Errath Placido Argüelles Delgado Ulrike Wießpeiner Henrika Voit-Augustin Robert Grims Friedrich Kaltenböck Eva Maria Kober Andreas Schöpfer Gottfried Fuchs |
| author_facet | Gerhard Schwarz Maximilian Errath Placido Argüelles Delgado Ulrike Wießpeiner Henrika Voit-Augustin Robert Grims Friedrich Kaltenböck Eva Maria Kober Andreas Schöpfer Gottfried Fuchs |
| author_sort | Gerhard Schwarz |
| collection | DOAJ |
| description | It is widely accepted that brain death (BD) is a diagnosis based on clinical examination. However, false-positive and false-negative evaluation results may be serious limitations. Ancillary tests are used when there is uncertainty about the reliability of the neurologic examination. Computed tomography angiography (CTA) is an ancillary test that tends to have the lowest false-positive rates. However, there are various influencing factors that can have an unfavorable effect on the validity of the examination method. There are inconsistent protocols regarding the evaluation criteria such as scoring systems. Among the most widely used different scoring systems the 4-point CTA-scoring system has been accepted as the most reliable method. Appropriate timing and/or Doppler pre-testing could reduce the number of possible premature examinations and increase the sensitivity of CTA in diagnosing cerebral circulatory arrest (CCA). In some cases of inconclusive CTA, the whole brain computed tomography perfusion (CTP) could be a crucial adjunct. Due to the increasing significance of CTA/CTP in determining BD, the methodology (including benefits and limitations) should also be conveyed via innovative electronic training tools, such as the BRAINDEXweb teaching tool based on an expert system. |
| first_indexed | 2024-03-09T03:35:06Z |
| format | Article |
| id | doaj.art-fab186d7b6ee4c22b2891a5c6fb1f18d |
| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-09T03:35:06Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-fab186d7b6ee4c22b2891a5c6fb1f18d2023-12-03T14:50:04ZengMDPI AGLife2075-17292022-10-011210155110.3390/life12101551Computed Tomography Angiography (CTA) in Selected Scenarios with Risk of Possible False-Positive or False-Negative Conclusions in Diagnosing Brain DeathGerhard Schwarz0Maximilian Errath1Placido Argüelles Delgado2Ulrike Wießpeiner3Henrika Voit-Augustin4Robert Grims5Friedrich Kaltenböck6Eva Maria Kober7Andreas Schöpfer8Gottfried Fuchs9Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, A-8036 Graz, AustriaInstitute for Medical Informatics, Statistics and Documentation, Medical University of Graz, A-8036 Graz, AustriaDepartment of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, A-8036 Graz, AustriaDivision of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, A-8036 Graz, AustriaDepartment of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, A-8036 Graz, AustriaDepartment of Dermatology, Medical University of Graz, A-8036 Graz, AustriaDepartment of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, A-8036 Graz, AustriaDivision of Anaesthesiology and Intensive Care Medicine, LKH Feldbach-Fürstenfeld, A-8330 Feldbach, AustriaDepartment of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, A-8036 Graz, AustriaDepartment of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, A-8036 Graz, AustriaIt is widely accepted that brain death (BD) is a diagnosis based on clinical examination. However, false-positive and false-negative evaluation results may be serious limitations. Ancillary tests are used when there is uncertainty about the reliability of the neurologic examination. Computed tomography angiography (CTA) is an ancillary test that tends to have the lowest false-positive rates. However, there are various influencing factors that can have an unfavorable effect on the validity of the examination method. There are inconsistent protocols regarding the evaluation criteria such as scoring systems. Among the most widely used different scoring systems the 4-point CTA-scoring system has been accepted as the most reliable method. Appropriate timing and/or Doppler pre-testing could reduce the number of possible premature examinations and increase the sensitivity of CTA in diagnosing cerebral circulatory arrest (CCA). In some cases of inconclusive CTA, the whole brain computed tomography perfusion (CTP) could be a crucial adjunct. Due to the increasing significance of CTA/CTP in determining BD, the methodology (including benefits and limitations) should also be conveyed via innovative electronic training tools, such as the BRAINDEXweb teaching tool based on an expert system.https://www.mdpi.com/2075-1729/12/10/1551brain deathcomputed tomography angiographycomputed tomography perfusioncerebral blood perfusionneuroimagingexpert system |
| spellingShingle | Gerhard Schwarz Maximilian Errath Placido Argüelles Delgado Ulrike Wießpeiner Henrika Voit-Augustin Robert Grims Friedrich Kaltenböck Eva Maria Kober Andreas Schöpfer Gottfried Fuchs Computed Tomography Angiography (CTA) in Selected Scenarios with Risk of Possible False-Positive or False-Negative Conclusions in Diagnosing Brain Death Life brain death computed tomography angiography computed tomography perfusion cerebral blood perfusion neuroimaging expert system |
| title | Computed Tomography Angiography (CTA) in Selected Scenarios with Risk of Possible False-Positive or False-Negative Conclusions in Diagnosing Brain Death |
| title_full | Computed Tomography Angiography (CTA) in Selected Scenarios with Risk of Possible False-Positive or False-Negative Conclusions in Diagnosing Brain Death |
| title_fullStr | Computed Tomography Angiography (CTA) in Selected Scenarios with Risk of Possible False-Positive or False-Negative Conclusions in Diagnosing Brain Death |
| title_full_unstemmed | Computed Tomography Angiography (CTA) in Selected Scenarios with Risk of Possible False-Positive or False-Negative Conclusions in Diagnosing Brain Death |
| title_short | Computed Tomography Angiography (CTA) in Selected Scenarios with Risk of Possible False-Positive or False-Negative Conclusions in Diagnosing Brain Death |
| title_sort | computed tomography angiography cta in selected scenarios with risk of possible false positive or false negative conclusions in diagnosing brain death |
| topic | brain death computed tomography angiography computed tomography perfusion cerebral blood perfusion neuroimaging expert system |
| url | https://www.mdpi.com/2075-1729/12/10/1551 |
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