Prevalence and clinical significance of accidental findings in electron-beam tomographic scans for coronary artery calcification.
OBJECTIVE
To analyse the prevalence, and diagnostic and therapeutic consequences, of accidental findings in electron-beam tomographic scans performed for evaluation of coronary artery calcification.


RESULTS
A total of 1812 consecutive patients with known or suspected coronary artery disease underwent electron-beam tomography. In 583 (32%) of the patients, i.v. contrast was also administered for non-invasive coronary angiography. A total of 2055 non-coronary pathological findings were observed in 953 (53%) of the patients. The prevalence of extra-cardiac disease, as shown in native scans and contrast studies, was assessed separately. In 583 (32%) patients, cardiac structures or the pericardium were affected, in 423 (23%) aortic disease was found. Lung disease was found in 357 (20%), and pathology of other organs in 273 patients (15%). The most frequent findings were aortic calcium in 423 (23%) patients and heart valve calcification in 317 patients (17%). Malignant disease could be detected in three patients. Further diagnostic investigations were done in 191 (11%) patients, 141 (74%) of which concerned the heart. In 22 (1.2%) patients, specific therapy was initiated following electron-beam tomographic findings.


CONCLUSIONS
Accidental non-coronary pathology is a frequent finding in electron-beam tomographic calcium scanning, and often requires diagnostic or therapeutic action. Profound knowledge of the radiological differential diagnosis of the thoracic organs is necessary for reporting electron-beam tomographic scans, in order to avoid misdiagnosis and to receive a high quality interpretation.
Hunold
P
P
Department of Cardiology, University of Essen, Germany.
Schmermund
A
A
Seibel
R M
RM
Grönemeyer
D H
DH
Erbel
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002118:Calcium / Q000032:analysis; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003327:Coronary Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006351:Heart Valves / Q000000981:diagnostic imaging; D006548:Hernia, Diaphragmatic / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D008297:Male; D008477:Mediastinal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging; D010995:Pleural Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D015995:Prevalence; D013131:Spine / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
D002118:Calcium