Technetium-99m ethylene cysteine dimer posterior fossa perfusion and brain death
Usha A Joseph,1 Kunal Kothari,2 Dayna Skolkin,3 David Q Wan,1 Isis W Gayed1
1Department of Radiology and Nuclear Medicine, University of Texas Medical School at Houston, TX; 2Department of Diagnostic Radiology, University of Maryland Medical Center, Baltimore, MD; 3Bachelor of Nursing Student, University of Texas at Austin, TX, USA
Background: The purpose of this study was to evaluate the frequency of and outcome in patients with isolated posterior fossa uptake on cerebral perfusion scan.
Methods: A retrospective review was undertaken of electronic medical records over 6 years from 713 consecutive patients undergoing technetium-99m ethyl cysteine dimer cerebral perfusion scans to identify isolated posterior fossa activity.
Results: Of the 13 patients with isolated posterior fossa activity, 10 deteriorated to death and three had life support withdrawn. They survived an average of 0.24 day ± 0.27 standard deviation (SD) days after scanning and an average of 1.03 ± 0.33 SD days on life support.
Conclusion: Unilateral or bilateral isolated posterior fossa technetium-99m ethyl cysteine dimer activity indicates imminent or impending brain death and a poor prognosis.
Keywords: isolated posterior fossa activity, cerebral perfusion scan, brain death, technetium-99m ethyl cysteine dimer
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