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Reporting incidental coronary, aortic valve and cardiac calcification on non-gated thoracic computed tomography, a

Michelle Claire Williams1,2, Ausami Abbas3, Erica Tirr4

  • 1University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, Edinburgh, UK.

The British Journal of Radiology
|October 14, 2020
PubMed

Insights

Incidental coronary artery calcification on thoracic CT scans is common and indicates increased cardiovascular risk. Reporting this finding can guide management of cardiovascular risk factors and potential heart disease.

Area of Science:

  • Radiology
  • Cardiology
  • Preventive Medicine

Background:

  • Incidental coronary and cardiac calcifications are frequently observed on non-gated thoracic CT scans.
  • Coronary artery calcification (CAC) serves as a significant marker for coronary artery disease (CAD) and is linked to adverse prognosis.

Purpose of the Study:

  • To recommend the systematic review and reporting of incidental cardiac calcifications on all visualized thoracic CT scans.
  • To establish a simple scoring system for reporting CAC and guide subsequent patient management.

Main Methods:

  • Review of all non-gated thoracic CT scans where the heart is visualized.
  • Utilizing a patient-based scoring system (none, mild, moderate, severe) for reporting coronary artery calcification.
  • Incorporating recommendations for assessing modifiable cardiovascular risk factors and standard chest pain guidelines.

Main Results:

  • Coronary artery calcification is a frequent incidental finding on non-gated thoracic CT.
  • Aortic valve calcification and aortic root dilation may also be identified and should be reported.
  • Other cardiac calcifications (mitral valve/annulus, pericardium, myocardium) are often incidental with no significant clinical impact.

Conclusions:

  • The heart should be routinely reviewed on all thoracic CT scans where it is visible.
  • Reporting incidental coronary artery calcification using a standardized score is recommended for all non-gated thoracic CTs.
  • Management recommendations, including risk factor assessment, should be included in reports for incidental findings.

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