دورية أكاديمية
Increased reliability of CT-imaging signs of bleeding into soft tissue in patients with COVID-19 for planning transarterial embolization.
العنوان: | Increased reliability of CT-imaging signs of bleeding into soft tissue in patients with COVID-19 for planning transarterial embolization. |
---|---|
المؤلفون: | Polyaev AY; Moscow Multidisciplinary Clinical Center 'Kommunarka', P. Kommunarka, Sosenskij Stan Str., 8, 108814, Moscow, Russia. apolyaev@yandex.ru., Tyagunov AE; Moscow Multidisciplinary Clinical Center 'Kommunarka', P. Kommunarka, Sosenskij Stan Str., 8, 108814, Moscow, Russia.; Department of Faculty Surgery №1 Pirogov Russian National Research Medical University (Pirogov Medical University), Ostrovityanova Str., 1, 117997, Moscow, Russia., Polonsky AA; Moscow Multidisciplinary Clinical Center 'Kommunarka', P. Kommunarka, Sosenskij Stan Str., 8, 108814, Moscow, Russia., Vinogradov VN; Moscow Municipal Hospital #1 n.a. N.I. Pirogov, Leninskij Prospect, 1, 119049, Moscow, Russia., Trudkov DY; Moscow Multidisciplinary Clinical Center 'Kommunarka', P. Kommunarka, Sosenskij Stan Str., 8, 108814, Moscow, Russia.; Department of Faculty Surgery №1 Pirogov Russian National Research Medical University (Pirogov Medical University), Ostrovityanova Str., 1, 117997, Moscow, Russia., Mosin SV; Moscow Multidisciplinary Clinical Center 'Kommunarka', P. Kommunarka, Sosenskij Stan Str., 8, 108814, Moscow, Russia., Stradymov EA; Moscow Multidisciplinary Clinical Center 'Kommunarka', P. Kommunarka, Sosenskij Stan Str., 8, 108814, Moscow, Russia.; Department of Faculty Surgery №1 Pirogov Russian National Research Medical University (Pirogov Medical University), Ostrovityanova Str., 1, 117997, Moscow, Russia., Baglaenko MV; Department of Faculty Surgery №1 Pirogov Russian National Research Medical University (Pirogov Medical University), Ostrovityanova Str., 1, 117997, Moscow, Russia., Sazhin AV; Department of Faculty Surgery №1 Pirogov Russian National Research Medical University (Pirogov Medical University), Ostrovityanova Str., 1, 117997, Moscow, Russia. |
المصدر: | Abdominal radiology (New York) [Abdom Radiol (NY)] 2023 Mar; Vol. 48 (3), pp. 1164-1172. Date of Electronic Publication: 2023 Jan 24. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 101674571 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2366-0058 (Electronic) NLM ISO Abbreviation: Abdom Radiol (NY) Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: [New York] : Springer, [2016]- |
مواضيع طبية MeSH: | COVID-19* , Embolization, Therapeutic*/methods, Humans ; Contrast Media ; Retrospective Studies ; Reproducibility of Results ; Hemorrhage/therapy ; Tomography, X-Ray Computed/methods |
مستخلص: | 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. (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.) |
References: | Furlan A, Fakhran S, Federle MP. Spontaneous abdominal hemorrhage: causes, CT findings, and clinical implications. AJR Am J Roentgenol 2009; 193:1077–1087. (PMID: 10.2214/AJR.08.223119770332) Federle MP, Pan KT, Pealer KM. CT criteria for differentiating abdominal hemorrhage: anticoagulation or aortic aneurysm rupture? AJR Am J Roentgenol 2007; 188:1324–1330. (PMID: 10.2214/AJR.05.191117449778) Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020; 8(5): 475–81. https://doi.org/10.1016/S2213-2600(20)30079-5 . (PMID: 10.1016/S2213-2600(20)30079-5321056327102538) Palumbo D, Guazzarotti G, De Cobelli F. Spontaneous major hemorrhage in COVID-19 patients: another brick in the wall of SARS-CoV-2-associated coagulation disorders? J Vasc Interv Radiol. 2020; 31(9): 1494–6. (PMID: 10.1016/j.jvir.2020.06.010327682777311899) Touma L, Cohen S, Cassinotto C, et al. Transcatheter arterial embolization of spontaneous soft tissue hematomas: a systemic review. Cardiovasc Interv Radiol 2019; 42:335–343. (PMID: 10.1007/s00270-018-2086-x) López-Martínez L, Molina-Nuevo JD, Pedrosa-Jiménez MJ, Juliá-Mollá E. Spontaneous Haematomas in Anticoagulated COVID-19 Patients: Diagnosis and Treatment by Embolization [published online ahead of print, 2022 Jan 28]. Cardiovasc Intervent Radiol. 2022;1–6. https://doi.org/10.1007/s00270-021-03049-z . Nematihonar, B., Qaderi, S., Shah, J. et al. Spontaneous giant rectus sheath hematoma in patients with COVID-19: two case reports and literature review. Int J Emerg Med 14, 40 (2021). https://doi.org/10.1186/s12245-021-00366-5 . (PMID: 10.1186/s12245-021-00366-5343011868300980) Caleo O, Bocchini G, Paoletta S, Ierardi AM, Scionti A, Tonerini M, Guida F, Sica G, Perillo A, Carrafiello G, Scaglione M. Spontaneous non-aortic retroperitoneal hemorrhage: etiology, imaging characterization and impact of MDCT on management. A multicentric study. Radiol Med. 2015 Jan; 120(1):133-48. https://doi.org/10.1007/s11547-014-0482-0 . Epub 2015 Jan 9. PMID: 25572538. (PMID: 10.1007/s11547-014-0482-025572538) Doham A, Darnige L, Sapoval M, Pellerin O. Spontaneous soft tissue hematomas. Diagn Interv Imaging. 2015; 96 :789–796. https://doi.org/10.1016/j.diii.2015.03.014 . (PMID: 10.1016/j.diii.2015.03.014) Nakamura H, Ouchi G, Miyagi K, et al. Case Report: Iliopsoas Hematoma during the Clinical Course of Severe COVID-19 in Two Male Patients. Am J Trop Med Hyg? 2021; 104(3):1018–1021. Published 2021 Jan 13. https://doi.org/10.4269/ajtmh.20-1507 . Zissin R, Ellis M, Gayer G. The CT findings of abdominal anticoagulant-related hematomas. Semin Ultrasound CT MR 2006;27(2):117—25. (PMID: 10.1053/j.sult.2006.01.00816623366) Zissin, R, Gayer, G, Kots, E, Ellis, M, Bartal, G, Griton, I. Transcatheter arterial embolisation in anticoagulant-related haematoma– a current therapeutic option: a report of four patients and review of the literature. Int J Clin Pract 2007; 61:1321–1327. (PMID: 10.1111/j.1742-1241.2006.01207.x17343658) Jawhari R, Chevallier O, Falvo N, d'Athis P, Gehin S, Charles PE, Midulla M, Loffroy R. Outcomes of Transcatheter Arterial Embolization with a Modified N-Butyl Cyanoacrylate Glue for Spontaneous Iliopsoas and Rectus Sheath Hematomas in Anticoagulated Patients. J Vasc Interv Radiol. 2018 Feb; 29(2):210–217. https://doi.org/10.1016/j.jvir.2017.08.006 . Semeraro V, Vidali S, Borghese O, et al. Glue Embolization in the Management of Rectus Sheath Hematomas. Vascular and Endovascular Surgery. 2022; 56(3):269-276. https://doi.org/10.1177/15385744211068742 . (PMID: 10.1177/1538574421106874235068270) Dohan A., Sapoval M., Chousterman B.G., di Primio M., Guerot E., Pellerin O. Spontaneous Soft-Tissue Hemorrhage in Anticoagulated Patients: Safety and Efficacy of Embolization. AJR Am. J. Roentgenol. 2015;204:1303–1310. https://doi.org/10.2214/AJR.14.12578 . (PMID: 10.2214/AJR.14.1257826001242) Elyaspour Z, Zibaeenezhad MJ, Razmkhah M, Razeghian-Jahromi I. Is It All About Endothelial Dysfunction and Thrombosis Formation? The Secret of COVID-19. Clin Appl Thromb Hemost. 2021;27:10760296211042940. https://doi.org/10.1177/10760296211042940. (PMID: 10.1177/10760296211042940346937548543709) Ackermann, M. et al. Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in COVID-19. N. Engl. J. Med. https://doi.org/10.1056/NEJMoa2015432 (2020). (PMID: 10.1056/NEJMoa2015432333853047412750) Teuwen, L.A., Geldhof, V., Pasut, A. & Carmeliet, P. COVID-19: the vasculature unleashed. Nat. Rev. Immunol. https://doi.org/10.1038/s41577-020-0343-0 (2020). (PMID: 10.1038/s41577-020-0343-0324996357270747) Varga, A. et al. Endothelial cell infection and endothelilitis in COVID-19. Lancet 395, 1417–1418 (2020). (PMID: 10.1016/S0140-6736(20)30937-5323250267172722) Goshua G., et al. Endotheliopathy is essential in COVID-19 associated coagulopathy. EHA Congress. Abstract LB2605.,. National Institute for Health and Care Excellence. COVID-19 rapid guideline: reducing the risk of venous thromboembolism in over 16s with COVID-19. Nov 2020. Ibukuro, Kenji MD; Oishi, Atsuro MD; Tanaka, Rei MD; Fukuda, Hozumi MD; Abe, Shoko MD Signal Flare Phenomenon as Active Bleeding in Retroperitoneal Hematoma With Hematocrit Effect on Dynamic CT Scan, Journal of Computer Assisted Tomography: September 2006 - Volume 30 - Issue 5 - p 787–790 https://doi.org/10.1097/01.rct.0000224632.32821 . Pierro A, Cilla S, Modugno P, Centritto EM, De Filippo CM, Sallustio G. Spontaneous rectus sheath hematoma: The utility of CT angiography. Radiol Case Rep. 2018 Feb 3; 13(2):328-332. https://doi.org/10.1016/j.radcr.2018.01.016 . PMID: 29904466; PMCID: PMC6000050. (PMID: 10.1016/j.radcr.2018.01.016.PMID:29904466;PMCID:PMC6000050299044666000050) Swensen, S.J., McLeod, R.A. and Stephens, D.H., 1984. CT of extracranial hemorrhage and hematomas. American journal of roentgenology, 143(4), pp.907-912. (PMID: 10.2214/ajr.143.4.9076332504) Nakayama M, Kato K, Yoshioka K, Sato H. Coagulopathy-related soft tissue hematoma: a comparison between computed tomography findings and clinical severity. Acta Radiologica Open. May 2020. https://doi.org/10.1177/2058460120923266 . (PMID: 10.1177/2058460120923266325287277263130) Tyagunov AE, Polyaev AY, Stradymov EA, Nechay TV, Trudkov DY, Mosin SV, Tyurin IN, Sazhin AV. Komp'yuternaya tomografiya i rentgenendovaskulyarnaya okklyuziya v diagnostike i lechenii spontannykh krovotechenii v myagkie tkani bryushnoi, grudnoi stenok i zabryushinnogo prostranstva u bol'nykh COVID-19 [Computed tomography and endovascular occlusion in diagnosis and treatment of spontaneous bleeding into soft tissues of abdominal, chest wall and retroperitoneal space in patients with COVID-19]. Khirurgiia (Mosk). 2022;(12):11–19. Russian. https://doi.org/10.17116/hirurgia202212111 . PMID: 36469464. Knisely A, Zhou ZN, Wu J, Huang Y, Holcomb K, Melamed A, Advincula AP, Lalwani A, Khoury-Collado F, Tergas AI, St Clair CM, Hou JY, Hershman DL, D'Alton ME, Huang YY, Wright JD. Perioperative Morbidity and Mortality of Patients With COVID-19 Who Undergo Urgent and Emergent Surgical Procedures. Ann Surg. 2021 Jan 1;273(1):34–40. https://doi.org/10.1097/SLA.0000000000004420 . PMID: 33074900; PMCID: PMC7737869. Ryazantsev A.A., Balgiev O.M., Grishin G.P., Litvina O.P., Profutkin A.I. Ultrasound in soft-tissue hematoma diagnosis in patients with COVID-19. Ultrasound and Functional Diagnostics. 2021; 4: 79–93. https://doi.org/10.24835/1607-0771-2021-4-79-93 (in Russian). Shimura T, Kurano M, Kanno Y, Ikeda M, Okamoto K, Jubishi D, Harada S, Okugawa S, Moriya K, Yatomi Y. Clot waveform of APTT has abnormal patterns in subjects with COVID-19. Sci Rep. 2021 Mar 4;11(1):5190. https://doi.org/10.1038/s41598-021-84776-8 . PMID: 33664450; PMCID: PMC7933409. (PMID: 10.1038/s41598-021-84776-8.PMID:33664450;PMCID:PMC7933409336644507933409) Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020 Apr;18(4):844–847. https://doi.org/10.1111/jth.14768 . Epub 2020 Mar 13. PMID: 32073213; PMCID: PMC7166509. Tiralongo F, Seminatore S, Di Pietro S, Distefano G, Galioto F, Vacirca F, Giurazza F, Palmucci S, Venturini M, Scaglione M, Basile A. Spontaneous Retroperitoneal Hematoma Treated with Percutaneous Transarterial Embolization in COVID-19 Era: Diagnostic Findings and Procedural Outcome. Tomography. 2022 May 1;8(3):1228-1240. https://doi.org/10.3390/tomography8030101 . PMID: 35645387; PMCID: PMC9149958. (PMID: 10.3390/tomography8030101.PMID:35645387;PMCID:PMC9149958356453879149958) |
فهرسة مساهمة: | Keywords: COVID-19; CT; Embolization; Extravasation; Hematoma; Non-surgical treatment; Ongoing bleeding; Spontaneous bleeding |
المشرفين على المادة: | 0 (Contrast Media) |
تواريخ الأحداث: | Date Created: 20230124 Date Completed: 20230224 Latest Revision: 20230311 |
رمز التحديث: | 20230311 |
مُعرف محوري في PubMed: | PMC9872064 |
DOI: | 10.1007/s00261-023-03810-7 |
PMID: | 36692545 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2366-0058 |
---|---|
DOI: | 10.1007/s00261-023-03810-7 |