Heparin-induced thrombocytopenia CT
Heparin-induced thrombocytopenia |
Differentiating Heparin-induced thrombocytopenia from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Shyam Patel [2]
Overview
CT
CT scan is not specific for a diagnosis of HIT, but a CT scan can be useful to assess for thrombotic manifestations of HIT, such as stroke, pulmonary embolism, mesenteric ischemia, intraabdominal or retroperitoneal bleeding, or acute limb ischemia.
- CT of the head in a patient with thrombotic stroke can show hypodensity suggestive of infarcted brain tissue. Alternatively, intracranial bleeding from thrombocytopenia will present radiographically as a hyperdensity on CT.[1]
- CT of the chest in a patient with pulmonary embolism from HIT can show Hampton's hump, Westermark's sign, or Fleischner's sign, similar to a chest X-ray.[1]
- CT of the abdomen or pelvis in a patient with mesenteric ischemia can show evidence of bowel necrosis. A retroperitoneal bleed or intraabdominal bleed from thrombocytopenia will show hyperdensity in the area of the bleeding.
- CT of the extremities in a patient with acute limb ischemic can show evidence of an ischemic limb. CT should be done with a runoff study to visualize the passage of dye through the arterial or venous circulation of the extremity.
Reference
- ↑ 1.0 1.1 Linkins LA, Dans AL, Moores LK, Bona R, Davidson BL, Schulman S; et al. (2012). "Treatment and prevention of heparin-induced thrombocytopenia: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines". Chest. 141 (2 Suppl): e495S–e530S. doi:10.1378/chest.11-2303. PMC 3278058. PMID 22315270.