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Increased reliability of CT-imaging signs of bleeding into soft tissue in patients with COVID-19 for planning transarterial embolization
INTRODUCTION: Spontaneous bleeding into the soft tissues of the abdominal and thoracic wall is described as complication of anticoagulant therapy. Computed tomography (CT) allows to detect the presence of extravasation of the contrast agent into a hematoma, which is indicated as a sign of ongoing bl...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9872064/ https://www.ncbi.nlm.nih.gov/pubmed/36692545 http://dx.doi.org/10.1007/s00261-023-03810-7 |
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author | Polyaev, A. Yu. Tyagunov, A. E. Polonsky, A. A. Vinogradov, V. N. Trudkov, D. Yu. Mosin, S. V. Stradymov, E. A. Baglaenko, M. V. Sazhin, A. V. |
author_facet | Polyaev, A. Yu. Tyagunov, A. E. Polonsky, A. A. Vinogradov, V. N. Trudkov, D. Yu. Mosin, S. V. Stradymov, E. A. Baglaenko, M. V. Sazhin, A. V. |
author_sort | Polyaev, A. Yu. |
collection | PubMed |
description | INTRODUCTION: Spontaneous bleeding into the soft tissues of the abdominal and thoracic wall is described as complication of anticoagulant therapy. Computed tomography (CT) allows to detect the presence of extravasation of the contrast agent into a hematoma, which is indicated as a sign of ongoing bleeding. Other specific CT signs of such coagulopathic bleeding have been described earlier. AIM OF THE STUDY: To evaluate the significance of specific coagulopathic CT signs for predicting the dynamics of spontaneous bleeding into soft tissues in patients with COVID-19. MATERIALS AND METHODS: A retrospective study included 60 patients with COVID-19 with spontaneous bleeding into soft tissues and extravasation of a contrast agent on CT. In addition to extravasation, a “hematocrit effect” was detected in 43 patients on CT. Of these, 39 had extravasation in the form of a “signal flare.” All patients underwent transarterial catheter angiography (TCA). To assess the prognostic value of CT signs, the results of CT and TCA compared. The absence of extravasation on the TCA more often corresponded to stopped bleeding. RESULTS: Extravasation on TCA found in 27 (45%) patients. The presence of the “hematocrit effect” or the combination of this sign with the phenomenon of a “signal flare” on CT (n = 43) led to more frequent confirmation of extravasation on TCA than in their absence (n = 17): 23.5% vs. 53.4% (p = 0.028). CONCLUSION: The presence of a fluid level and the phenomenon of a “signal flare” on CT in the structure of spontaneous hematomas of the soft tissues of the abdominal and thoracic wall in COVID-19 patients more often corresponded to ongoing bleeding on the TCA. The absence of coagulopathic CT signs more often corresponded to stopped bleeding. GRAPHICAL ABSTRACT: [Image: see text] |
format | Online Article Text |
id | pubmed-9872064 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-98720642023-01-25 Increased reliability of CT-imaging signs of bleeding into soft tissue in patients with COVID-19 for planning transarterial embolization Polyaev, A. Yu. Tyagunov, A. E. Polonsky, A. A. Vinogradov, V. N. Trudkov, D. Yu. Mosin, S. V. Stradymov, E. A. Baglaenko, M. V. Sazhin, A. V. Abdom Radiol (NY) Interventional Radiology INTRODUCTION: Spontaneous bleeding into the soft tissues of the abdominal and thoracic wall is described as complication of anticoagulant therapy. Computed tomography (CT) allows to detect the presence of extravasation of the contrast agent into a hematoma, which is indicated as a sign of ongoing bleeding. Other specific CT signs of such coagulopathic bleeding have been described earlier. AIM OF THE STUDY: To evaluate the significance of specific coagulopathic CT signs for predicting the dynamics of spontaneous bleeding into soft tissues in patients with COVID-19. MATERIALS AND METHODS: A retrospective study included 60 patients with COVID-19 with spontaneous bleeding into soft tissues and extravasation of a contrast agent on CT. In addition to extravasation, a “hematocrit effect” was detected in 43 patients on CT. Of these, 39 had extravasation in the form of a “signal flare.” All patients underwent transarterial catheter angiography (TCA). To assess the prognostic value of CT signs, the results of CT and TCA compared. The absence of extravasation on the TCA more often corresponded to stopped bleeding. RESULTS: Extravasation on TCA found in 27 (45%) patients. The presence of the “hematocrit effect” or the combination of this sign with the phenomenon of a “signal flare” on CT (n = 43) led to more frequent confirmation of extravasation on TCA than in their absence (n = 17): 23.5% vs. 53.4% (p = 0.028). CONCLUSION: The presence of a fluid level and the phenomenon of a “signal flare” on CT in the structure of spontaneous hematomas of the soft tissues of the abdominal and thoracic wall in COVID-19 patients more often corresponded to ongoing bleeding on the TCA. The absence of coagulopathic CT signs more often corresponded to stopped bleeding. GRAPHICAL ABSTRACT: [Image: see text] Springer US 2023-01-24 2023 /pmc/articles/PMC9872064/ /pubmed/36692545 http://dx.doi.org/10.1007/s00261-023-03810-7 Text en © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Interventional Radiology Polyaev, A. Yu. Tyagunov, A. E. Polonsky, A. A. Vinogradov, V. N. Trudkov, D. Yu. Mosin, S. V. Stradymov, E. A. Baglaenko, M. V. Sazhin, A. V. Increased reliability of CT-imaging signs of bleeding into soft tissue in patients with COVID-19 for planning transarterial embolization |
title | Increased reliability of CT-imaging signs of bleeding into soft tissue in patients with COVID-19 for planning transarterial embolization |
title_full | Increased reliability of CT-imaging signs of bleeding into soft tissue in patients with COVID-19 for planning transarterial embolization |
title_fullStr | Increased reliability of CT-imaging signs of bleeding into soft tissue in patients with COVID-19 for planning transarterial embolization |
title_full_unstemmed | Increased reliability of CT-imaging signs of bleeding into soft tissue in patients with COVID-19 for planning transarterial embolization |
title_short | Increased reliability of CT-imaging signs of bleeding into soft tissue in patients with COVID-19 for planning transarterial embolization |
title_sort | increased reliability of ct-imaging signs of bleeding into soft tissue in patients with covid-19 for planning transarterial embolization |
topic | Interventional Radiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9872064/ https://www.ncbi.nlm.nih.gov/pubmed/36692545 http://dx.doi.org/10.1007/s00261-023-03810-7 |
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