From the Department of Biofluid Mechanics, Technical University of Applied Sciences Regensburg, Regensburg, Germany.
Regensburg Center of Biomedical Engineering, OTH and University Regensburg, Regensburg, Germany.
ASAIO J. 2020 Aug;66(8):922-928. doi: 10.1097/MAT.0000000000001089.
Coagulative disorders, especially clotting during extracorporeal membrane oxygenation, are frequent complications. Direct visualization and analysis of deposits in membrane oxygenators using computed tomography (CT) may provide an insight into the underlying mechanisms causing thrombotic events. However, the already established multidetector CT (MDCT) method shows major limitations. Here, we demonstrate the feasibility of applying industrial micro-CT (µCT) to circumvent these restrictions. Three clinically used membrane oxygenators were investigated applying both MDCT and µCT. The scans were analyzed in terms of clot volume and local clot distribution. As validation, the clot volume was also determined from the fluid volume, which could be filled into the respective used oxygenator compared to a new device. In addition, cross-sectional CT images were compared with crosscut oxygenators. Based on the µCT findings, a morphological measure (sphericity) for assessing clot structures in membrane oxygenators is introduced. Furthermore, by comparing MDCT and µCT results, an augmentation of the MDCT method is proposed, which allows for improved clot volume determination in a clinical setting.
凝血障碍，特别是体外膜肺氧合期间的凝血，是常见的并发症。使用计算机断层扫描（CT）直接观察和分析膜式氧合器中的沉积物，可以深入了解导致血栓形成事件的潜在机制。然而，已经建立的多排 CT（MDCT）方法存在明显的局限性。在这里，我们展示了应用工业用微计算机断层扫描（µCT）来规避这些限制的可行性。对三种临床应用的膜式氧合器进行了研究，同时应用 MDCT 和 µCT。根据血栓体积和局部血栓分布情况对扫描结果进行了分析。作为验证，还通过与新设备相比，从可注入到相应使用的氧合器中的流体体积确定了血栓体积。此外，还比较了横截面 CT 图像与切割氧合器。基于 µCT 的结果，引入了一种形态学指标（球形度）来评估膜式氧合器中的血栓结构。此外，通过比较 MDCT 和 µCT 的结果，提出了一种 MDCT 方法的增强方法，该方法可在临床环境中提高血栓体积的确定准确性。
