Disseminated Intravascular Coagulation in Aortic Aneurysms: Assessment of Consumption Site Using Labeled-Platelet Scintigraphy

Abstract

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) (4hrs) and 1.09±0.15 (48 hrs) after injection; the aneurysm/liver ratio was 0.56 ± 0.16 (4hrs) 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.

Key words

Aortic aneurysm - Isotope labeled platelet scintigraphy - Disseminated intravascular coagulation - Active platelet consumption site