MR 'hot nose sign' and 'intravascular enhancement sign' in brain death.

Three cases of MR with gadopentetate dimeglumine in patients diagnosed with cerebral death are presented. Observation of an MR "hot nose sign" and an "intravascular enhancement sign" provided additional imaging support in the clinical diagnosis of brain death. The MR findings in brain death include: 1) transtentorial and foramen magnum herniation, 2) absent intracranial vascular flow void, 3) poor gray matter/white matter differentiation, 4) no intracranial contrast enhancement, 5) carotid artery enhancement (intravascular enhancement sign), and 6) prominent nasal and scalp enhancement (MR hot nose sign). Additional modalities for confirming brain death are discussed.