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Possibilities of combined use of the skin and soft tissues ultrasound and laser doppler visualization in hematoma diagnosis and monitoring in patients with COVID-19

DOI: https://doi.org/10.29296/25879979-2022-05-08
Issue: 
5
Year: 
2022

Borsukov A.V.(1), Gorbatenko O.A(1), Venidiktova D.Yu.(1), Tagil A.O.(1), Borsukov S.A.(1), Kruglova А.А.(2), Kurchenkova V.S.(2), Ahmedova A.R.(2)
1-Smolensk State Medical University, the Ministry of Health of the Russian Federation, Fundamental research laboratory “Diagnostic researches and minimally invasive technologies”. Krupskoy street 28, Smolensk, Russia, 214019
2-Clinical City Hospital No. 1, department of diagnostic and minimally invasive technologies. Frunze street 40, Smolensk, Russia, 214006

Relevance: coagulopathy is a serious complication of coronavirus infection (COVID-19), while the use of anticoagulants is a mandatory component of patient therapy and is associated with an increased risk of hemorrhagic complications and hematomas of various localization. Objective: to evaluate the effectiveness of the integrated use of high-frequency ultrasound examination of the skin and laser Doppler imaging in the diagnosis (detection, assessment of the condition) and monitoring of hematomas in patients with COVID-19 with the involvement of nursing staff in the study. Materials and methods: in 2019 - 2022 the study was conducted of patients with confirmed coronavirus infection who are being treated in an infectious diseases hospital with subcutaneous hematomas (soft tissues), including 37 women (56%), 29 men (44%), mean age 48±3.5. All patients were examined according to a single diagnostic algorithm, which included 4 stages: Stage 1. Examination of hematomas by specialists (infectionist and surgeon) with a conclusion (n=66). Stage 2. Examination of hematomas using an ultrasound linear probe with a frequency of 7-13 MHz (n=66). Stage 3. Investigation of hematomas using a high-frequency (48 MHz) ultrasonic probe with the evaluation of standard parameters with the measurement of the pixel index (n=66). Stage 4. The study of hematomas using laser doppler imaging with an assessment of the rate, perfusion and blood flow concentration in the study area (n=66). The patients were divided into groups according to the hematoma development (with or without complications). Results and Discussion: to assess the effectiveness of using a comprehensive diagnostic algorithm, we monitored the trend of natural development of hematomas in patients with COVID-19. Correlation of data of high-frequency ultrasound diagnostics corresponds to r=0.86; laser Doppler imaging r=0.76; complex diagnostic algorithm r=0.91 (sensitivity 88%, specificity 91%). Conclusions: high-frequency ultrasound examination of the skin and laser doppler imaging can be used in combination to detect, assess the condition and monitor the development of subcutaneous hematomas in patients with COVID-19.

Keywords: 
ultrasound examination of the skin
hematoma
coronavirus infection
laser Doppler imaging



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