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Extra-cardiac findings at cardiac CT: experience with 1,764 patients

Jay Koonce1, Joseph U Schoepf, Shaun A Nguyen

  • 1Department of Radiology, Medical University of South Carolina, Charleston, SC 29425, USA.

European Radiology
|October 18, 2008
PubMed

Insights

Incidental extra-cardiac findings (ECF) are common in cardiac CT scans, particularly with coronary artery CT angiography and bypass graft studies. These findings impact patient management, with 18% requiring follow-up.

Area of Science:

  • Radiology
  • Cardiovascular Imaging
  • Medical Diagnostics

Background:

  • Incidental extra-cardiac findings (ECF) are frequently discovered during cardiac CT examinations.
  • Understanding the prevalence and clinical significance of ECFs based on CT indication is crucial for patient management.

Purpose of the Study:

  • To investigate the incidence and characteristics of incidental extra-cardiac findings (ECF) detected during cardiac CT.
  • To compare the frequency of ECFs across different cardiac CT indications: calcium scoring (CS), coronary CT angiography (CTA), pulmonary vein stenosis (PVS), and coronary artery bypass graft (CABG) imaging.

Main Methods:

  • Retrospective review of 1,764 cardiac CT reports (January 2004 - December 2006).
  • ECFs were categorized by examination type, anatomical location, and clinical significance.
  • Statistical comparisons were performed between different cardiac CT indications.

Main Results:

  • A total of 507 ECFs were identified in 441 patients (25.0%).
  • Clinically important ECFs requiring follow-up were found in 18.4% of patients.
  • ECFs were significantly more frequent in coronary artery bypass graft (CABG) studies (38.6%) and coronary CT angiography (CTA) (26.6%) compared to calcium scoring (CS) (17.1%).
  • Statistically significant differences (p < 0.05) were observed between CABG and other indications, and between CTA and CS for both incidental and clinically important findings.

Conclusions:

  • Incidental extra-cardiac findings are common in cardiac CT, with a substantial proportion being clinically significant.
  • Coronary artery bypass graft imaging and coronary CT angiography are associated with a higher incidence of ECFs compared to calcium scoring.
  • These findings underscore the importance of careful review of cardiac CT studies for ECFs to optimize patient care.

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