Document Detail

Extra-cardiac findings on coronary computed tomography scanning.
MedLine Citation:
PMID:  19070293     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cardiac computed tomography scans include several extra-cardiac structures such as mediastinum, lung parenchyma and upper abdominal organs. A variety of abnormalities in those structures might be clinically important and in some cases might explain the patient's complaints. OBJECTIVES: To analyze consecutive CCT examinations for the prevalence and clinical significance of extra-cardiac findings. METHODS: Cardiac CT scans of 134 sequential patients (104 males, 30 females) aged 20-77 (mean 54 years) with suspected coronary artery disease were prospectively and independently reviewed by a consensus of two radiologists for the presence of lung, mediastinal, pleural, upper abdominal and skeletal abnormalities. CT scans with extra-cardiac abnormalities were divided into two groups: group A- defined as "clinically significant" or "potentially significant findings" - consisted of patients requiring further evaluation or follow-up, and group B - "clinically non-significant findings." RESULTS: Extra-cardiac abnormalities were found in 103 of the 134 patients (76.8%). Group A abnormalities were found in 52/134 patients (39%), while group B abnormalities were seen in 85/134 (63%). The most common abnormalities in group A were non-calcified lung nodules (> 4 mm) noted in 17/134 patients (13%), followed by enlarged mediastinal lymph nodes (> 10 mm) in 14/134 (10%), diaphragmatic hernia (2 cm) in 12/134 (9%), moderate or severe degenerative spine disease in 12/134 (9%), and emphysema and aortic aneurysm in 6 patients each (4.5%). A malignant lung tumor was noted in one patient. CONCLUSIONS: There is a high prevalence of non-cardiac abnormalities in patients undergoing CCT. Clinically significant or potentially significant findings can be expected in 40% of patients who undergo CCT, and these will require further evaluation and follow-up. The reporting radiologist should be experienced in chest imaging.
Inesa Greenberg-Wolff; Livnat Uliel; Orly Goitein; Joseph Shemesh; Judith Rozenman; Elio Di Segni; Eli Konen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Israel Medical Association journal : IMAJ     Volume:  10     ISSN:  1565-1088     ISO Abbreviation:  Isr. Med. Assoc. J.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-12-16     Completed Date:  2009-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100930740     Medline TA:  Isr Med Assoc J     Country:  Israel    
Other Details:
Languages:  eng     Pagination:  806-8     Citation Subset:  IM    
Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.
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MeSH Terms
Carcinoid Tumor / complications,  radiography
Coronary Artery Disease / complications*,  radiography*
Lung Diseases / complications,  radiography
Middle Aged
Prospective Studies
Solitary Pulmonary Nodule / complications,  radiography
Thoracic Diseases / complications*,  radiography
Tomography, X-Ray Computed*
Young Adult

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