Cardiac and pericardial abnormalities on chest computed tomography: what can we see?

Area of Science:

• Radiology
• Cardiology
• Medical Imaging

Background:

• Chest computed tomography (CT) predominantly focuses on pulmonary and mediastinal structures.
• Incidental cardiac abnormalities detected on chest CT are frequently overlooked or misdiagnosed.
• Accurate identification of cardiac findings on non-gated CT is crucial for patient management.

Purpose of the Study:

• To present a structured method for cardiac assessment during routine non-electrocardiographic-gated (non-ECG-gated) chest CT.
• To illustrate common and uncommon cardiac abnormalities detectable on non-ECG-gated chest CT.
• To improve the diagnostic accuracy of incidental cardiac findings in radiology.

Main Methods:

• Pictorial review of cardiac findings on non-ECG-gated chest CT.
• Stepwise approach to cardiac structure evaluation.
• Categorization of common and less frequent cardiac abnormalities.

Main Results:

• A systematic approach can effectively identify cardiac abnormalities on non-ECG-gated chest CT.
• Common findings include pericardial effusion, cardiac masses, and coronary artery calcification.
• Less frequent findings encompass cardiomyopathies and congenital heart anomalies.

Conclusions:

• Integrating cardiac assessment into routine chest CT interpretation enhances diagnostic yield.
• Radiologists should be aware of potential cardiac pathologies visible on non-ECG-gated scans.
• This approach can prevent misdiagnosis and guide appropriate patient care.