Extra-cardiac findings on coronary computed tomography scanning

Area of Science:

• Radiology
• Cardiovascular Imaging
• Thoracic Imaging

Background:

• Cardiac computed tomography (CCT) visualizes numerous extra-cardiac structures.
• Abnormalities in these structures can be clinically important and may explain patient symptoms.

Purpose of the Study:

• To determine the prevalence and clinical significance of extra-cardiac findings on CCT examinations.
• To assess the proportion of CCT scans with abnormalities requiring further clinical action.

Main Methods:

• Prospective review of CCT scans from 134 patients with suspected coronary artery disease.
• Independent assessment by two radiologists for lung, mediastinal, pleural, upper abdominal, and skeletal abnormalities.
• Classification of findings into clinically significant (Group A) and non-significant (Group B).

Main Results:

• Extra-cardiac abnormalities were detected in 76.8% of patients.
• Clinically significant findings (Group A) were present in 39% of patients.
• Common significant findings included lung nodules, enlarged mediastinal lymph nodes, diaphragmatic hernia, and degenerative spine disease.

Conclusions:

• A high prevalence of non-cardiac abnormalities exists in CCT scans.
• Approximately 40% of CCT examinations yield clinically significant findings necessitating further investigation.
• Radiologists interpreting CCT scans require expertise in chest imaging.