Literature DB >> 18043387

Prevalence and significance of incidental extracardiac findings at 64-multidetector coronary CTA.

Jacobo Kirsch1, Philip A Araoz, Frederick B Steinberg, Joel G Fletcher, Cynthia H McCollough, Eric E Williamson.   

Abstract

INTRODUCTION: Computed tomography (CT) angiography of the coronaries has the ability to depict extracardiac lesions in the visualized thorax and upper abdomen. These incidental lesions can often present a challenge to physicians.
METHODS: We performed a retrospective review of 100 consecutive patients referred for 64-multidetector CT coronary CT angiography performed on a 64-slice CT scanner. Two fellowship trained cardiac radiologists reviewed each study by consensus on a CT postprocessing workstation using commercially available software. Extracardiac CT findings (ECF) were classified as benign, indeterminate, or of clinical significance at the time of image evaluation. Benign findings were those considered to be of little clinical significance with no follow-up needed. Indeterminate findings were those deemed of potential clinical importance, requiring correlation of the patient history or a follow-up study. Clinically significant findings were those felt to be of definite clinical importance requiring immediate evaluation or intervention.
RESULTS: The study cohort consisted of 68 males (68%) and 32 females (32%) with a mean (+/-standard deviation) age of 63.4+/-14.5 years and a range of 23 to 87 years. A total of 145 ECF were found in 67 patients (67%), 50 males and 17 females, with a mean age of 68.0+/-11.8 years and a range of 23 to 87 years. Of those, 107 (73.8%) were considered benign, 22 (15.2%) indeterminate, and 16 clinically significant findings (11.0%). By significance, a total of 107 benign ECF were found in 61 patients, 46 males and 15 females, with a mean age of 67.7+/-12.2 years and a range of 23 to 87 years. Only 22 ECF indeterminate findings were present, distributed in 21 patients, of which there were 17 males and 5 females, with a mean age of 68.5+/-13.9 and a range of 23 to 82 years. The 16 clinically significant ECF were distributed in 11 patients, all males, with a mean age of 68.0+/-8.8 and a range of 55 to 87 years.
CONCLUSIONS: The presence of ECF in our daily practice is frequent, and not limited to the identification of pulmonary nodules, and reinforces the notion that all the organs in the scan should be thoroughly and methodically evaluated.

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Year:  2007        PMID: 18043387     DOI: 10.1097/RTI.0b013e31813434a9

Source DB:  PubMed          Journal:  J Thorac Imaging        ISSN: 0883-5993            Impact factor:   3.000


  18 in total

Review 1.  Cardiac computed tomographic angiography: evaluation of non-cardiac structures.

Authors:  Samuel Wann; Peter Rao; Roger Des Prez
Journal:  J Nucl Cardiol       Date:  2009-01-20       Impact factor: 5.952

2.  Incidental extracardiac findings at coronary CT: clinical and economic impact.

Authors:  Christoph I Lee; Emily B Tsai; Bronislava M Sigal; Sylvia K Plevritis; Alan M Garber; Geoffrey D Rubin
Journal:  AJR Am J Roentgenol       Date:  2010-06       Impact factor: 3.959

3.  Incidental extracardiac findings at cardiac CT angiography: comparison of prevalence and clinical significance between precontrast low-dose whole thoracic scan and postcontrast retrospective ECG-gated cardiac scan.

Authors:  Jin Woo Kim; Eun-Young Kang; Hwan Seok Yong; Yoon Kyung Kim; Ok Hee Woo; Yu-Whan Oh; Ki Yeol Lee; Heon Han
Journal:  Int J Cardiovasc Imaging       Date:  2009-01-09       Impact factor: 2.357

4.  A fateful kiss: the use of CT coronary angiogram in the diagnosis of non-cardiac chest pathology.

Authors:  Rabia Topan; Tom Hyde
Journal:  BMJ Case Rep       Date:  2012-08-24

5.  Extracoronary abnormalities on coronary magnetic resonance angiography in the multiethnic study of atherosclerosis study: frequency and clinical significance.

Authors:  Jens Vogel-Claussen; Debiao Li; James Carr; Kiang Liu; Moyses Szklo; Joao A C Lima; David A Bluemke
Journal:  J Comput Assist Tomogr       Date:  2009 Sep-Oct       Impact factor: 1.826

6.  Reduced z-axis technique for CT Pulmonary angiography in pregnancy--validation for practical use and dose reduction.

Authors:  Kaushik Shahir; Jonathan M McCrea; Luis Antonio Sosa Lozano; Lawrence R Goodman
Journal:  Emerg Radiol       Date:  2015-08-25

7.  Extra-cardiac findings at cardiac CT: experience with 1,764 patients.

Authors:  Jay Koonce; Joseph U Schoepf; Shaun A Nguyen; Meredith C Northam; James G Ravenel
Journal:  Eur Radiol       Date:  2008-10-17       Impact factor: 5.315

8.  Extracardiac findings on coronary computed tomography angiography in patients without significant coronary artery disease.

Authors:  Philipp Karius; Alexander Lembcke; Felix C Sokolowski; Ivan Dario Perez Gandara; Alejandra Rodríguez; Bernd Hamm; Marc Dewey
Journal:  Eur Radiol       Date:  2018-09-25       Impact factor: 5.315

9.  Incidental non-cardiac findings of a coronary angiography with a 128-slice multi-detector CT scanner: should we only concentrate on the heart?

Authors:  Olga Lazoura; Katerina Vassiou; Theodora Kanavou; Marianna Vlychou; Dimitrios L Arvanitis; Ioannis V Fezoulidis
Journal:  Korean J Radiol       Date:  2009-12-28       Impact factor: 3.500

10.  Incidental pulmonary nodules in emergent coronary CT angiography for suspected acute coronary syndrome: Impact of revised 2017 Fleischner Society Guidelines.

Authors:  Jan-Erik Scholtz; Michael T Lu; Sandeep Hedgire; Nina M Meyersohn; George R Oliveira; Anand M Prabhakar; Rajiv Gupta; Mannudeep K Kalra; Jo-Anne O Shepard; Udo Hoffmann; Brian B Ghoshhajra
Journal:  J Cardiovasc Comput Tomogr       Date:  2017-11-14
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