Wieland Staab1, Leonard Bergau2, Joachim Lotz3, Christian Sohns4. 1. Institute for Diagnostic and Interventional Radiology, Heart Center, University Medical Center Göttingen, Robert-Koch-Str. 40, 37099 Göttingen, Germany; DZHK, German Center for Heart Research, Göttingen, Germany. Electronic address: wieland.staab@med.uni-goettingen.de. 2. DZHK, German Center for Heart Research, Göttingen, Germany; Department of Cardiology and Pneumology, Heart Center, University Medical Center Göttingen, Göttingen, Germany. 3. Institute for Diagnostic and Interventional Radiology, Heart Center, University Medical Center Göttingen, Robert-Koch-Str. 40, 37099 Göttingen, Germany; DZHK, German Center for Heart Research, Göttingen, Germany. 4. DZHK, German Center for Heart Research, Göttingen, Germany; Department of Cardiology and Pneumology, Heart Center, University Medical Center Göttingen, Göttingen, Germany; Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom.
Abstract
OBJECTIVE: This study sought to determine the prevalence of significant and nonsignificant noncardiac findings in patients undergoing preprocedural dual-source CT (DSCT) before transcatheter aortic valve implantation (TAVI). METHODS: Patients (n = 204; aged, 80.5 ± 5.1 years; 106 men) underwent preprocedural DSCT of the thoracoabdominal aorta and the pelvic arterial vessels. Noncardiac findings were recorded and categorized as nonsignificant (group A), incidental findings requiring follow-up examinations (group B), and significant findings with a demand for clinical treatment (group C). RESULTS: In 60 of 204 DSCT examinations (29.4%) no noncardiac findings were observed. Of the remaining 144 examinations (70.6%), 260 had noncardiac findings; 35 of 204 patients (17.1%) had a total of 37 clinically significant noncardiac findings. Eight malignancies were detected; 5 of them were incidentally diagnosed on DSCT and changed patient management. A total of 223 nonsignificant findings were observed in 116 of 204 patients (56.9%; group A), the most frequent findings were pleural effusions or colorectal diverticulosis. The prevalence of incidental and significant findings on DSCT before TAVI increased with patient age (r(2) = 0.69; P = .01). CONCLUSION: Significant noncardiac findings are common in patients referred to routine preprocedural DSCT for planning TAVI (17.1%).
OBJECTIVE: This study sought to determine the prevalence of significant and nonsignificant noncardiac findings in patients undergoing preprocedural dual-source CT (DSCT) before transcatheter aortic valve implantation (TAVI). METHODS:Patients (n = 204; aged, 80.5 ± 5.1 years; 106 men) underwent preprocedural DSCT of the thoracoabdominal aorta and the pelvic arterial vessels. Noncardiac findings were recorded and categorized as nonsignificant (group A), incidental findings requiring follow-up examinations (group B), and significant findings with a demand for clinical treatment (group C). RESULTS: In 60 of 204 DSCT examinations (29.4%) no noncardiac findings were observed. Of the remaining 144 examinations (70.6%), 260 had noncardiac findings; 35 of 204 patients (17.1%) had a total of 37 clinically significant noncardiac findings. Eight malignancies were detected; 5 of them were incidentally diagnosed on DSCT and changed patient management. A total of 223 nonsignificant findings were observed in 116 of 204 patients (56.9%; group A), the most frequent findings were pleural effusions or colorectal diverticulosis. The prevalence of incidental and significant findings on DSCT before TAVI increased with patient age (r(2) = 0.69; P = .01). CONCLUSION: Significant noncardiac findings are common in patients referred to routine preprocedural DSCT for planning TAVI (17.1%).
Authors: Jonathan Hinton; Sam Gough; Hanad Ahmed; Lavinia Gabara; John Rawlins; Alison Calver; Benoy N Shah; Dhrubo Rakhit; James Shambrook; Stephen Harden; Charles Peebles; Ausami Abbas; Nick Curzen Journal: Br J Radiol Date: 2019-08-12 Impact factor: 3.039