ORIGINAL PAPER
What non-coronary incidental findings can a radiologist detect
in an ECG-gated computed tomography scan?
1
Collegium Medicum, Jan Kochanowski University, Kielce, Poland Head of the Collegium: Prof. Marianna Janion MD, PhD
2
Department of Diagnostic Imaging, Voivodeship Hospital, Kielce, Poland Head of the Department: Łukasz Wypchło MD
3
1st Department of Radiology, Medical University, Lublin, Poland Head of the Department: Andrzej Drop MD. PhD
Submission date: 2022-09-16
Acceptance date: 2022-10-08
Publication date: 2022-12-16
Medical Studies 2022;38(4):263-272
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Cardiac ECG-CT is the standard method of assessing atherosclerotic lesions of the coronary arteries. Radiologist should always evaluate all structures included in the study. Changes found during this “additional” assessment may have great importance in further diagnostic and therapeutic procedures.
Aim of the research:
To analyse the significance of all extracoronary findings detected in 230 multi-slice cardiac tomography examinations.
Material and methods:
The study retrospectively evaluated the results of 230 examinations of patients referred for ECG-CT. The study group consisted of 122 (53.0%) men and 108 (47.0%) women, aged 5–91 years, mean 57.6.
Results and conclusions:
In the study, all incidental findings (IFs) detected in 230 CT examinations were analysed, and their total number was 1816 (7.9 /examination). IFs were found in 227 (98.7%) results. At least one IF was described for all women and for 119 of 122 men. The detected IFs were divided according to their significance into changes that were clinically significant for the patient’s health or life (category 1) and not significant (category 2). Category 1 consisted of 1459 abnormalities (80.3%), and category 2 consisted of 357 (19.7%) IFs. In the study group, at least one clinically significant IF was reported in 105/108 women (97.2%) and in 113/122 men (92.6%). Moreover, 3 subcategories were distinguished in the group of I: category 1a – changes significant without the need for further diagnostic procedures (613 abnormalities – 33.8%); category 1b – significant changes in which further planned diagnostic or therapeutic procedures are indicated – 815 (44.9%); and category 1c – significant changes requiring urgent procedures – 31 (1.7%).
Cardiac ECG-CT is the standard method of assessing atherosclerotic lesions of the coronary arteries. Radiologist should always evaluate all structures included in the study. Changes found during this “additional” assessment may have great importance in further diagnostic and therapeutic procedures.
Aim of the research:
To analyse the significance of all extracoronary findings detected in 230 multi-slice cardiac tomography examinations.
Material and methods:
The study retrospectively evaluated the results of 230 examinations of patients referred for ECG-CT. The study group consisted of 122 (53.0%) men and 108 (47.0%) women, aged 5–91 years, mean 57.6.
Results and conclusions:
In the study, all incidental findings (IFs) detected in 230 CT examinations were analysed, and their total number was 1816 (7.9 /examination). IFs were found in 227 (98.7%) results. At least one IF was described for all women and for 119 of 122 men. The detected IFs were divided according to their significance into changes that were clinically significant for the patient’s health or life (category 1) and not significant (category 2). Category 1 consisted of 1459 abnormalities (80.3%), and category 2 consisted of 357 (19.7%) IFs. In the study group, at least one clinically significant IF was reported in 105/108 women (97.2%) and in 113/122 men (92.6%). Moreover, 3 subcategories were distinguished in the group of I: category 1a – changes significant without the need for further diagnostic procedures (613 abnormalities – 33.8%); category 1b – significant changes in which further planned diagnostic or therapeutic procedures are indicated – 815 (44.9%); and category 1c – significant changes requiring urgent procedures – 31 (1.7%).
REFERENCES (45)
1.
Turek Ł, Sadowski M, Janion-Sadowska A, Kurzawski J, Jaroszyński A. Skrzeplina uszka lewego przedsionka u pacjentów kierowanych do kardiowersji elektrycznej z powodu typowego trzepotania przedsionków. Medical Studies 2022; 38: 132-139.
2.
Janion-Sadowska A, Turek Ł, Dudek A, Andrychowski J, Sadowski M. Migotanie i trzepotanie przedsionków – aktualny stan wiedzy. Część 1. Medical Studies 2021; 37: 151-161.
3.
Janion-Sadowska A, Turek Ł, Dudek A, Andrychowski J, Sadowski M. Migotanie i trzepotanie przedsionków – aktualny stan wiedzy. Część 2. Medical Studies 2021; 37: 239-249.
4.
Bugajska E, Czekajska-Chehab E, Uhlig S, Drop A. Jakie zmiany pozasercowe może wykryć radiolog w EKG-KT u pacjentów skierowanych z podejrzeniem choroby wieńcowej? (What non-cardiac lesions may detected by ECG-CT in patients with suspected coronary disease?) Pol J Radiol 2007; 72 Suppl. 1.
5.
Kay FU, Canan A, Abbara S. Common incidental findings on cardiac CT: a systematic review. Curr Cardiovasc Imaging Rep 2019; 12: 21.
6.
Chaosuwannakit N, Makarawate P. Prevalence and clinical significance of incidental extracardiac findings in cardiac magnetic resonance imaging. Kardiochir Torakochir Pol 2018; 15: 241-245.
7.
Law YM, Huang J, Chen K, Cheah FK, Chua T. Prevalence of significant extacoronary findings on multislice CT coronary angiography examinations and coronary artery calcium scoring examinations. J Med Imaging Radiat Oncol 2006; 52: 49-56.
8.
Kirsch J, Araoz PA, Steinberg FB, Fletcher JG, McCol- lough CH, Williamson EE. Prevalence and significance of incidental extracardiac findings at 64-multidetector coronary CTA. J Thorac Imaging 2007; 22: 330-334.
9.
Gil BN, Ran K, Tamar G, Shmuell F, Eli A. Prevalence of significant noncardiac findings on coronary multidetector computed tomography angiography in asymptomatic patients. J Comput Assist Tomogr 2007; 31: 1-4.
10.
Aglan I, Jodocy D, Hiehs S, Soegner P, Frank R. Prevalence of extracardiac findings in patients undergoing coronary computed tomography and additional low-dose whole-body computed tomography. Eur J Radiol 2010; 74: 166-174.
11.
Koonce J, Schoepf JU, Nguyen SA, Northam MC, Rave- nel JG. Extra-cardiac findings at cardiac CT: experience with 1,764 patients. Eur Radiol 2009; 19: 570-576.
12.
Ibrahim AS, Aya YE, Shokeiry W, Tantawyw H. Value of “large FOV” calcium score as a screening method for detection of extracardiac incidental findings. Egypt J Radiol Nuclear Med 2015; 46: 615-620.
13.
Cademartiri F, Malago R, Belgrano M, Alberghine F, Maffei E, La Grutta L, Palumbo AA, Runza G, Mollet NR, Midiri M, Krestein GP, Mucelli RP. Spectrum of collateral findings in multislice CT coronary angiography. Radiol Med 2007; 112: 937-948.
14.
Elgin EE, O’Malley PG, Feuerstein I, Taylor AJ. Frequency and severity of “incidentalomas” encountered during electron beam computed tomography for coronary calcium in middle-aged army personnel. Am J Cardiol 2002; 90: 543-554.
15.
Lazoura, O, Vassiou K, Kanavou T, Vlychou M, Arvanitis DL, Fezoulidis IV. Incidental non-cardiac findings of a coronary angiography with a 128-slice multi-detector CT scanner: should we only concentrate on the heart? Korean J Radiol 2010; 11: 60-68.
16.
McKenna DA, Laxipati M, Colletti PM. The prevalence of incidental findings at cardiac MRI. Open Cardiovasc Med J 2008; 2: 20-25.
17.
Gravina M, Stoppino LP, Casavecchia G, Moffa AP, Vin- ci R, Brunetti ND, Di Biase M, Macarini L. Incidental extracardiac findings and their characterization on cardiac MRI. BioMed Res Int 2017; 2017: 2423546.
18.
La Grutta L, Malago R, Maffei E, Barbiani C, Pezzato A, Martini C, Arcadi T, Clemente A, Mollet NR, Zuccarelli A, Krestin GP, LagallaR, Mucelli RP, Cademartiri F, Midiri M. Collateral non cardiac findings in clinical routine CT coronary angiography: results from a multi-center registry. Radiol Med 2015; 120: 1122-1129.
19.
MacHaalany J, Yam Y, Ruddy TD, Abraham A, Chen L, Beanlands RS, Chow BJ. Potential clinical and economic consequences of noncardiac incidental findings on cardiac computed tomography. J Am Coll Cardiol 2009; 54: 1533-1541.
20.
White CS, Kuo D, Kelemen M, Jain V, Musk A, Aidi E, Read K, Sliker C, Prasad R. Chest pain evaluation in the emergency department: can MDCT provide a comprehensive evaluation? Am J Roentgenol 2005; 185: 533-540.
21.
Venkatesh V, You JJ, Landry DJ, Ellins ML, Sheth T. Extracardiac findings in cardiac computed tomographic angiography in patients at low to intermediate risk for coronary artery disease. Canadian Assoc Radiol J 2009; 61: 286-290.
22.
Fahran A, Haider Z, Chishti I, Jameel Z, Burhan D. Non coronary findings on contrast enhanced cardiac MDCT. PJR 2008; 18: 1.
23.
Dewey M, Hoffmann H, Hamm B. Multislice CT coronary angiography: effect of sublingual nitroglycerine on the diameter of coronary arteries. Rofo 2006; 178: 600-604.
24.
Greenberg-Wolff I, Uliel LL, Goitein O, Shemesh J, Rozenman J, Di Segni E, Konen E. Extra-cardiac findings on coronary computed tomography scanning. Israel Med Assoc J 2008; 10: 806-808.
25.
Lee CI, Tsai EB, Sigal BM, Plevritis SK, Garber AM, Ru- bin GD. Incidental extracardiac findings at coronary CT: clinical and economic impact. AJR Am J Roentgenol 2010; 194: 1531-1538.
26.
Haller S, Kaiser C, Buser P, Bongartz G, Bremerich J. Coronary artery imaging with contrast-enhanced MDCT: extracardiac findings. Am J Roentgenol 2006; 187: 105-110.
27.
Mizouni H, Derbali W, Mormeche J, Radhouani I, Chemli S, Menif E. Anomalies extra-cardiaques de découverte fortuite en coroscanner. La Tunisie Medicale 2012; 90: 394-396.
28.
Sohns JM, Menke J, Staab W, Spiro J, Fasshauer M, Kowallick JT, Bergau L, Zwaka PA, Unterberg-Buchwald C, Lotz J, Schwartz A. Current role of cardiac and extra-cardiac pathologies in clinically indicated cardiac computed tomography with emphasis on status before pulmonary vein isolation. Fortschr Röntgenstr 2014; 186: 860-867.
29.
Kim TJ, Han DH, Jin KN, Lee KW. Lung cancer detected at cardiac CT: prevalence, clinicoradiologic features, and importance of full-field-of-view images. Radiology 2010; 255: 369-376.
30.
Chia PL, Kaw G, Wansaicheong G, Ho KT. Prevalence of non-cardiac findings in a large series of patients undergoing cardiac multi-detector computed tomography scans. Int J Cardiovasc Imaging 2009; 25: 537-543.
31.
Kawano Y, Tamura A, Goto Y, Shinozaki K, Zaizen H, Kadota J. Incidental detection of cancers and other non-cardiac abnormalities on coronary multislice computed tomography. Am J Cardiol 2007; 99: 1608-1609.
32.
Bendix K, Jensen JM, Poulsen S, Mygind N. Coronary dual source multi detector computed tomography in patients suspected of coronary artery disease: prevalence of incidental extra-cardiac findings. Eur J Radiol 2011; 80: 109-114.
33.
Boldeanu I, Perreault Bishop J, Nepveu S, Stevens LM, Soulez G, Kieser TM, Lamy A, Noiseux N, Chartrand-Lefebvre C. Incidental findings in CT imaging of coronary artery bypass grafts: results from a Canadian multicenter prospective cohort. BMC Res Notes 2018; 11: 72.
34.
Sohns C, Sossalla S, Vollmann D, Luethje L, Seegers J, Schmitto JD, Zebel M, Obenauer S. Extra cardiac findings by 64-multidetector computed tomography in patients with symptomatic atrial fibrillation prior to pulmonal vein isolation. Int J Cardiovasc Imaging 2011; 27: 127-134.
35.
Crum-Cianflone N, Stepenosky J, Medina S, Wessman D, Krause D, Boswell G. Clinically significant incidental findings among human immunodeficiency virus-infected men during computed tomography for determination of coronary artery calcium. Am J Cardiol 2016; 107: 633-637.
36.
Mueller J, Jeudy J, Poston R, White CS. Cardiac CT angiography after coronary bypass surgery: prevalence of incidental findings. AJR Am J Roentgenol 2007; 189: 414-419.
37.
Burt JR, Iribarren C, Fair JM, Norton LC, Mahbouba M, Rubin GD, Hlatky MA, Go AS, Fortmann SP. Incidental findings on cardiac multidetector row computed tomography among healthy older adults. Arch Intern Med 2008; 168: 756-761.
38.
Onuma Y, Tanabe K, Nakazawa G, Aoki J, Nakajima H, Ibukuro H, Hara K. Non-cardiac findings in coronary imaging with multi-detector computed tomography. J Am Coll Cardiol 2006; 48: 402-406.
39.
Cronin A, Aronow WS, Devabhakturi S, Young KA, Weiss MB, Belkin RN. Prenvalence of incidental noncardiac findings diagnosed by computer tomography in 875 consecutive patients in an academic outpatient cardiac computer tomography facility. Arch Med Sci 2008; 4: 401-403.
40.
Yoon YE, Chun EY, Choi EK, Cho Y, Lee W, Choi SI, Choi DJ, Chang JH. Non-cardiac findings on 64-slice cardiac multi-detector CT. Korean Circ J 2008; 38: 276-283.
41.
Horton KM, Post WS, Blumenthal RS, Fishman EK. Prevalence of significant noncardiac findings on electron-beam computed tomography coronary artery calcium screening examinations.. Circulation 2002; 106: 532-537.
42.
Schragin JG, Weissfeld JL, Edmundowicz D, Strollo D, Fuhrman CR. Non-cardiac findings on coronary electron beam computed tomography scanning. J Thorac Imaging 2004; 19: 82-86.
43.
Williams CM, Hunter A, Shah ASV, DReisbach J, Weir JR, Macmillan MT, Kirkbride R, Hawke F, Baird A, Mirasadraee S, van Beek EJR, Newby DE, Roditi G. Impact of noncardiac findings in patients undergoing CT coronary angiography: a substudy of the Scottish computed tomography of the heart (SCOT-HEART) trial. Eur Radiol 2018; 28: 2639-2646.
44.
Hunold P, Schmermund A, Seibel RM, Gronemeyer DH, Erbel R. Prevalence and clinical significance of accidental findings in electron beam tomographic scans for coronary artery calcification. Eur Heart J 2001; 22: 1748-1758.
45.
Karius P, Lembcke A, Sokolowski F, Perez Gandara ID, Rodrigez A, Hamm B, Dewey M. Extracardiac findings on coronary computed tomography angiography in patients without significant coronary artery disease. Eur Radiol 2019; 29: 1714-1723.
| eISSN: | 2300-6722 |
| ISSN: | 1899-1874 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
