Disseminated intravascular coagulation in aortic aneurysms: assessment of consumption site using labeled-platelet scintigraphy.

Abstract

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