Abstract 2623: Significance and Implications of Non-cardiac Findings in Cardiac Multi-detector Computed Tomography Scans
Introduction: Multi-detector computed tomography (MDCT) studies are increasingly used to evaluate the heart and coronary arteries. The field of view includes other major structures in the chest and upper abdomen, resulting in occasional extra-cardiac findings. There have been proposals for radiologists and cardiologists to be jointly involved in reporting such scans. The purpose of this study was to determine the prevalence of non-cardiac findings in a large series of patients undergoing a cardiac MDCT scan.
Methods: All cardiac MDCT studies (16 and 64-slice) performed in our institution between 1 April 2004 and 30 April 2006 were reviewed. Non-cardiac findings were classified according to the organ of involvement and labeled as significant or non-significant. Significant findings were defined as abnormalities that warranted additional clinical or radiological follow-up.
Results: There were 1061 patients. A total of 104 non-cardiac findings were reported in 86 patients (8.1%). Significant findings (49 out of 104) included: pulmonary nodules > 1cm (8/16.3%), emphysema (7/14.3%), pneumonia (2/4.1%), pulmonary embolism (2/4.1%), interstitial lung disease (1/2.0%), pleural effusion (1/2.0%), pulmonary oedema (1/2.0%), endobronchial tuberculosis (1/2.0%), tuberculosis-related pleural plaques (1/2.0%), hepatic carcinomas (6/12.2%), hepatic hemangiomas (2/4.1%), aerobilia (1/2.0%), liver cysts > 5cm (2/4.1%), fatty liver (1/2.0%), adrenal hyperplasia (1/2.0%), ascites (2/4.1%), lymphoma (1/2.0%), thoracic aneurysms (3/6.1%), histiocytosis (1/2.0%), esophagitis (1/2.0%) and breast carcinoma (1/2.0%). Non-significant abnormalities (55 out of 104) included lung scarring (22/40%), liver cysts <5cm (17/30.9%), lung cysts (3/5.5%), lung blebs (1/1.8%), lung granuloma <1cm (1/1.8%), breast calcification (1/1.8%), spinal degenerative changes (3/5.5%), non-specific calcified lymph nodes (4/7.3%), aortic calcification (2/3.6%) and splenic flexure diverticulae (1/1.8%).
Conclusions: Of 1061 patients undergoing cardiac MDCT studies, 8.1% had non-cardiac findings. 47.1% of these abnormalities were significant and warranted further investigation.