Extra-cardiac findings on coronary computed tomography scanning.
BACKGROUND
Cardiac computed tomography scans include several extra-cardiac structures such as mediastinum, lung parenchyma and upper abdominal organs. A variety of abnormalities in those structures might be clinically important and in some cases might explain the patient's complaints.


OBJECTIVE
To analyze consecutive CCT examinations for the prevalence and clinical significance of extra-cardiac findings.


METHODS
Cardiac CT scans of 134 sequential patients (104 males, 30 females) aged 20-77 (mean 54 years) with suspected coronary artery disease were prospectively and independently reviewed by a consensus of two radiologists for the presence of lung, mediastinal, pleural, upper abdominal and skeletal abnormalities. CT scans with extra-cardiac abnormalities were divided into two groups: group A- defined as "clinically significant" or "potentially significant findings" - consisted of patients requiring further evaluation or follow-up, and group B - "clinically non-significant findings."


RESULTS
Extra-cardiac abnormalities were found in 103 of the 134 patients (76.8%). Group A abnormalities were found in 52/134 patients (39%), while group B abnormalities were seen in 85/134 (63%). The most common abnormalities in group A were non-calcified lung nodules (> 4 mm) noted in 17/134 patients (13%), followed by enlarged mediastinal lymph nodes (> 10 mm) in 14/134 (10%), diaphragmatic hernia (2 cm) in 12/134 (9%), moderate or severe degenerative spine disease in 12/134 (9%), and emphysema and aortic aneurysm in 6 patients each (4.5%). A malignant lung tumor was noted in one patient.


CONCLUSIONS
There is a high prevalence of non-cardiac abnormalities in patients undergoing CCT. Clinically significant or potentially significant findings can be expected in 40% of patients who undergo CCT, and these will require further evaluation and follow-up. The reporting radiologist should be experienced in chest imaging.
Greenberg-Wolff
Inesa
I
Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.
Uliel
Livnat
L
Goitein
Orly
O
Shemesh
Joseph
J
Rozenman
Judith
J
Di Segni
Elio
E
Konen
Eli
E
D000328:Adult; D000368:Aged; D002276:Carcinoid Tumor / Q000150:complications / Q000000981:diagnostic imaging; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D003074:Solitary Pulmonary Nodule / Q000150:complications / Q000000981:diagnostic imaging; D013896:Thoracic Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D055815:Young Adult