Published Online
on July 15, 2002

A more recent version of this article appeared on July 30, 2002

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Submitted on April 29, 2002
Revised on June 7, 2002
Accepted on June 10, 2002

Prevalence of Significant Noncardiac Findings on Electron-Beam Computed Tomography Coronary Artery Calcium Screening Examinations

Karen M. Horton MD^*, Wendy S. Post MD, Roger S. Blumenthal MD, and Elliot K. Fishman MD

From the Department of Radiology, Johns Hopkins Medical Institutions (K.M.H., E.K.F.), and the Department of Medicine, Johns Hopkins University (W.S.P., R.S.B.), Baltimore, Md.

^* To whom correspondence should be addressed. E-mail: kmhorton{at}jhmi.edu.

Background—Screening electron-beam computed tomography (EBCT) examinations for the detection and quantification of coronary artery calcification are being performed throughout the country. In addition to information about the heart, great vessels, and coronary arteries, these examinations include portions of the lungs, bony thorax, and upper abdomen. The purpose of this study was to determine the prevalence of significant noncardiac findings in a series of patients undergoing coronary artery calcification screening studies with EBCT scanning.

Methods and Results—Between January 1, 2001, and October 1, 2001, 1326 consecutive patients underwent coronary artery calcification screening with EBCT (3-mm-thick slices were obtained at 3-mm intervals). Two board-certified radiologists reviewed the examinations on a workstation using standard mediastinal windows, lung windows, and bone windows. Significant extracardiac abnormalities were noted. Of 1326 patients, 103 (7.8%) had significant extracardiac pathology requiring clinical or imaging follow-up. These included 53 patients with noncalcified lung nodules <1 cm, 12 patients with lung nodules 1 cm, 24 patients with infiltrates, 7 patients with indeterminate liver lesions, 2 patients with sclerotic bone lesions, 2 patients with breast abnormalities, 1 patient with polycystic liver disease, 1 patient with esophageal thickening, and 1 patient with ascites.

Conclusions—In this study, 7.8% of patients undergoing screening EBCT examinations for coronary artery calcification were found to have important extracardiac pathology requiring additional work-up. Therefore, it is essential that a radiologist review the entire examination.

Key words: calcium • radiography • computed tomography

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