Lipophile ^99 mTc-markierte Perfusionstracer zur Hirntoddiagnostik

Zusammenfassung

Der Nachweis eines zerebralen Perfusionsausfalls mittels lipophilen, Tc-99 m-markierten Radiopharmaka wie ^99 mTc-ECD und ^99 mTc-HMPAO kann als ergänzende Untersuchung zur Hirntodfeststellung eingesetzt werden. Vorteile des Verfahrens sind die fehlende Invasivität, die rasche Durchführbarkeit und die hohe Standardisierung. Es sind bislang keine Fälle berichtet, bei denen mit diesen Verfahren ein zerebraler Perfusionsausfall diagnostiziert worden wäre und die Diagnose des Hirntods nicht vorlag. Die besondere Verantwortung der Diagnostik setzt Erfahrung im Umgang mit den genannten Radiopharmaka und dem Untersuchungsablauf voraus.

Abstract

Technetium-99 m labelled lipophilic radiopharmaceuticals are well established in documenting the loss of cerebral perfusion in the context of brain death diagnosis. The procedures are non invasive, can easily be applied in intensive care patients and are highly standardized. No cases have been reported in whom a complete loss of cerebral perfusion has been diagnosed with ^99 mTc-ECD or ^99 mTc-HMPAO scintigraphy in whom the diagnosis of brain death has not been confirmed thereafter. Owing to the far reaching consequences of the diagnosis “brain death”, the procedures should only be employed by experienced nuclear medicine physicians.

Schlüsselwörter

Hirntod - zerebrale Perfusion - Szintigrafie

Key words

brain death - cerebral perfusion - scintigraphy

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