Heparin-induced thrombocytopenia CT

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Heparin-induced thrombocytopenia

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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. 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.

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