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Disseminated intravascular coagulation in aortic aneurysms: assessment of consumption site using labeled-platelet
Y Sakakibara1, T Takeda, M Hori
1Department of Surgery, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
Insights
111In-oxine labeled platelet scintigraphy helps locate active consumption sites in patients with aortic aneurysms, especially when disseminated intravascular coagulation (DIC) is suspected. This imaging technique provides valuable preoperative information for managing these complex cases.
Area of Science:
- Vascular Surgery
- Nuclear Medicine
- Hematology
Background:
- Disseminated intravascular coagulation (DIC) is a known complication associated with aortic aneurysms.
- Identifying the active consumption site is crucial for managing DIC in these patients.
Purpose of the Study:
- To assess the localization of the active consumption site in patients with chronic aortic aneurysms using platelet scintigraphy.
- To evaluate the utility of 111In-oxine labeled platelet scintigraphy in preoperative assessment for aortic aneurysms with suspected DIC.
Main Methods:
- 111In-oxine labeled autologous platelets were used for scintigraphy in 45 patients.
- Planar images were acquired at 4 and 48 hours post-injection.
- Radioactivity uptake was assessed visually and through region-of-interest analysis.
Main Results:
- Focal radioactivity accumulation in the aortic aneurysm was observed in 78% of patients.
- Negative uptake was more frequent in dissecting aortic aneurysms (46%) compared to true aneurysms (12.5%).
- Quantitative ratios (aneurysm/heart, aneurysm/liver, aneurysm/spleen) were calculated at different time points.
Conclusions:
- 111In-oxine labeled platelet scintigraphy is a useful preoperative tool for identifying the active consumption focus in aortic aneurysms.
- This imaging modality is particularly valuable when the clinical suspicion of DIC is high.
- The findings aid in understanding the localization of DIC activity within the aneurysm.
Background:
It is known that disseminated intravascular coagulation (DIC) may occur along with aortic aneurysms. To assess the localization of the active consumption site we performed 111In-oxine labeled platelet scintigraphy in patients with chronic aortic aneurysms.
Methods:
Images were obtained using 111In-oxine labeled autologous platelets in 45 patients. Planar images were taken twice (at 4 and 48 hrs) after injection. A visual inspection of the radioactivity uptake and special analysis in regions of interest were performed.
Results:
Thirty-five patients (78%) showed a focal accumulation of radioactivity in the aortic aneurysm. Six of 13 patients (46%) with dissecting aortic aneurysm, and 4 of 32 patients (12.5%) with true aneurysms were evaluated as negative uptake by scintigram (p < 0.05). The aneurysm/heart ratio was 0.85 +/- 0.16 (mean +/- SD) (4 hrs) and 1.09 +/- 0.15 (48 hrs) after injection; the aneurysm/liver ratio was 0.56 +/- 0.16 (4 hrs) and 0.38 +/- 0.09 (48 hrs); the aneurysm/spleen ratio was 0.39 +/- 0.07 (4 hrs) and 0.39 +/- 0.08 (48 hrs).
Conclusions:
When the probability of DIC is clinically high in patients with aortic aneurysms, 111In-oxine labeled platelet scintigraphy provides useful preoperative information regarding the location of the functionally active consumption focus.