title: Thoracic Pathologies on Scout Views and Bolus Tracking Slices for Computed Tomographic Cerebral Angiography.
abstract: OBJECTIVE
  To evaluate the incidence of additional thoracic pathologic findings (TPF) detected on scout views and corresponding bolus tracking slices (SVBT) for computed tomographic cerebral angiography (CTCA) and to test the reliability and accuracy of these findings.
  
  
  METHODS
  The study collective included 505 consecutive patients who underwent multidetector CTCA. Appendant SVBT of all patients were reviewed for any pathologic findings and patient medical reports were analyzed, if any medical treatment was initiated for the detected pathologic findings. In 18 patients thoracic CT scans were performed in the same session. These were additionally reviewed by two blinded observers to test for intra- and interobserver reliability as well as for accuracy of detecting thoracic pathologies on SVBT.
  
  
  RESULTS
  TPF were detected in 165 (33%) SVBT. The five most common pathologic findings were: pleural effusion, 12%; pneumonia, 8%; atelectasis/dystelecatsis, 6%; pericardial effusion, 2% and elevated diaphragm, 1%. For 48 % of these findings medical treatment was initiated. SVBT showed a sensitivity of 53%, a specificity of 99%, a positive predictive value of 89%, a negative predictive value of 94% and accuracy of 94% for the detection of TPF. The intraobserver reliability was very good and the interobserver reliability showed moderate agreement.
  
  
  CONCLUSIONS
  SVBT for CTCA should be reviewed with care by radiologists, since additional TPF can affect patient management. Nevertheless, despite a high specificity of SVBT for detecting TPF, an only moderate sensitivity has to be taken into account.
  
  
  CONCLUSIONS
  Thoracic pathologies are frequently found on scout views for cerebral CTA. Reviewing additional bolus trigger slices will improve diagnostic sensitivity. Despite high specificity, scout views and trigger slices offer a moderate sensitivity. Evaluation of scout views and trigger slices can result in medical treatment.
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Groth
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Fiehler
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: F O
authors.initials: FO
authors.lastname: Henes
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: J H
authors.initials: JH
authors.lastname: Buhk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D015588:Observer Variation; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013896:Thoracic Diseases / Q000000981:diagnostic imaging*