Heparin-induced thrombocytopenia CT

Heparin-induced thrombocytopenia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Shyam Patel [2]

## Overview[edit | edit source]

CT scan may be helpful in the diagnosis of complications of heparin induced thrombocytopenia, such as stroke, pulmonary embolism, mesenteric ischemia

## CT[edit | edit source]

There are no CT scan findings associated with heparin induced thrombocytopenia. However, a CT scan may be helpful in the diagnosis of complications of heparin induced thrombocytopenia, which include:

* Stroke
* Pulmonary embolism
* Mesenteric ischemia
* Intraabdominal or retroperitoneal bleeding
* 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 abdomen and pelvis can also be used to visualize bilateral adrenal hemorrhage, which has been shown to be a unique clinical manifestation of HIT.[2]

* 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[edit | edit source]

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.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
2. ↑ Rosenberger LH, Smith PW, Sawyer RG, Hanks JB, Adams RB, Hedrick TL (2011). "Bilateral adrenal hemorrhage: the unrecognized cause of hemodynamic collapse associated with heparin-induced thrombocytopenia". Crit Care Med. 39 (4): 833–8. doi:10.1097/CCM.0b013e318206d0eb. PMC 3101312. PMID 21242799.CS1 maint: Multiple names: authors list (link)

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