Skip to main content
Erschienen in: Wiener klinische Wochenschrift 15-16/2014

01.08.2014 | original article

The prevalence and clinical importance of incidentally detected noncoronary cardiovascular findings with coronary multidetector CT angiography

verfasst von: Cengiz Erol, MD, Mustafa Koplay, MD, Mehmet Şeker, MD, Yahya Paksoy, MD

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 15-16/2014

Einloggen, um Zugang zu erhalten

Summary

Objective

The purpose of this study was to determine the prevalence and clinical importance of incidental findings of noncoronary cardiac structures and mediastinal great vessels in patients who underwent coronary computed tomography angiography (CCTA).

Methods

The study included 2,096 consecutive patients (1,472 men and 624 women, with a mean age of 55 years). Cardiovascular findings were categorized into three groups according to the clinical importance: group 1 included findings necessitating immediate treatment or intervention; group 2 included findings requiring clinical awareness, follow-up, or further clinical and/or radiological investigations; and group 3 included findings not requiring any follow-up or further tests. We also evaluated whether there was any previous diagnosis of cardiovascular findings.

Results

A total of 174 abnormalities (8.3 %) were detected in 170 patients. Of these abnormalities, 21 findings (12 %) were considered as group 1, 121 (69.5 %) as group 2, and 32 (18.5 %) as group 3. The majority of cardiovascular findings (140 of 174, 80.5 %) were unknown by the reporter during the interpretation of CCTA examinations and regarded as incidental findings.

Conclusion

Noncoronary incidental cardiovascular findings in patients who underwent CCTA are common. It is important to be aware of these findings necessitating immediate treatment or intervention, and follow-up or further investigations, and careful attention must be paid to all the structures included in the images.
Literatur
1.
Zurück zum Zitat Van Ooijen PM, Dorgelo J, Zijlstra F, Oudkerk M. Detection, visualization and evaluation of anomalous coronary anatomy on 16-slice multidetector-row CT. Eur Radiol. 2004;14:2163–71.PubMedCrossRef Van Ooijen PM, Dorgelo J, Zijlstra F, Oudkerk M. Detection, visualization and evaluation of anomalous coronary anatomy on 16-slice multidetector-row CT. Eur Radiol. 2004;14:2163–71.PubMedCrossRef
2.
Zurück zum Zitat Henneman MM, Bax JJ, Schuijf JD, van der Wall EE. Noninvasive visualization of the coronary arteries with multi-slice computed tomography; influence of heart rate on diagnostic accuracy. Int J Cardiovasc Imaging. 2006;22:107–9.PubMedCrossRef Henneman MM, Bax JJ, Schuijf JD, van der Wall EE. Noninvasive visualization of the coronary arteries with multi-slice computed tomography; influence of heart rate on diagnostic accuracy. Int J Cardiovasc Imaging. 2006;22:107–9.PubMedCrossRef
3.
Zurück zum Zitat Kantarci M, Doganay S, Karcaaltincaba M, Karabulut N, Erol MK, Yalcin A, et al. Clinical situations where coronary CT angiography confers superior diagnostic information in comparison to invasive coronary angiography. Diagn Interv Radiol. 2012. doi:10.4261/1305-3825.DIR.5064-11.1. Kantarci M, Doganay S, Karcaaltincaba M, Karabulut N, Erol MK, Yalcin A, et al. Clinical situations where coronary CT angiography confers superior diagnostic information in comparison to invasive coronary angiography. Diagn Interv Radiol. 2012. doi:10.4261/1305-3825.DIR.5064-11.1.
4.
Zurück zum Zitat Hoey E, Ganeshan A, Nader K, Randhawa K, Watkin R. Cardiac neoplasms and pseudotumors: imaging findings on multidetector CT angiography. Diagn Interv Radiol. 2012;18:67–77.PubMed Hoey E, Ganeshan A, Nader K, Randhawa K, Watkin R. Cardiac neoplasms and pseudotumors: imaging findings on multidetector CT angiography. Diagn Interv Radiol. 2012;18:67–77.PubMed
5.
Zurück zum Zitat Lehman SJ, Abbara S, Cury RC, Nagurney JT, Hsu J, Goela A, Schlett CL, Dodd JD, Brady TJ, Bamberg F, Hoffmann U. Significance of cardiac computed tomography incidental findings in acute chest pain. Am J Med. 2009;122:543–9.PubMedCrossRef Lehman SJ, Abbara S, Cury RC, Nagurney JT, Hsu J, Goela A, Schlett CL, Dodd JD, Brady TJ, Bamberg F, Hoffmann U. Significance of cardiac computed tomography incidental findings in acute chest pain. Am J Med. 2009;122:543–9.PubMedCrossRef
6.
Zurück zum Zitat Kirsch J, Araoz PA, Steinberg FB, Fletcher JG, McCollough CH, Williamson EE. Prevalence and significance of incidental extracardiac findings at 64-multidetector coronary CTA. J Thorac Imaging. 2007;22:330–4.PubMedCrossRef Kirsch J, Araoz PA, Steinberg FB, Fletcher JG, McCollough CH, Williamson EE. Prevalence and significance of incidental extracardiac findings at 64-multidetector coronary CTA. J Thorac Imaging. 2007;22:330–4.PubMedCrossRef
7.
Zurück zum Zitat Law YM, Huang J, Chen K, Cheah FK, Chua T. Prevalence of significant extracoronary findings on multislice CT coronary angiography examinations and coronary artery calcium scoring examinations. J Med Imaging Radiat Oncol. 2008;52:49–56.PubMedCrossRef Law YM, Huang J, Chen K, Cheah FK, Chua T. Prevalence of significant extracoronary findings on multislice CT coronary angiography examinations and coronary artery calcium scoring examinations. J Med Imaging Radiat Oncol. 2008;52:49–56.PubMedCrossRef
8.
Zurück zum Zitat Sundaram B, Patel S, Agarwal P, Kazerooni EA. Anatomy and terminology for the interpretation and reporting of cardiac MDCT: part 2, CT angiography, cardiac function assessment, and noncoronary and extracardiac findings. AJR Am J Roentgenol. 2009;192:584–98.PubMedCrossRef Sundaram B, Patel S, Agarwal P, Kazerooni EA. Anatomy and terminology for the interpretation and reporting of cardiac MDCT: part 2, CT angiography, cardiac function assessment, and noncoronary and extracardiac findings. AJR Am J Roentgenol. 2009;192:584–98.PubMedCrossRef
9.
Zurück zum Zitat Kim JW, Kang EY, Yong HS, Kim YK, Woo OH, Oh YW, et al. Incidental extracardiac findings at cardiac CT angiography: comparison of prevalence and clinical significance between precontrast low-dose whole thoracic scan and postcontrast retrospective ECG-gated cardiac scan. Int J Cardiovasc Imaging. 2009;25:75–81.PubMedCrossRef Kim JW, Kang EY, Yong HS, Kim YK, Woo OH, Oh YW, et al. Incidental extracardiac findings at cardiac CT angiography: comparison of prevalence and clinical significance between precontrast low-dose whole thoracic scan and postcontrast retrospective ECG-gated cardiac scan. Int J Cardiovasc Imaging. 2009;25:75–81.PubMedCrossRef
10.
Zurück zum Zitat Aglan I, Jodocy D, Hiehs S, Soegner P, Frank R, Haberfellner B, et al. Clinical relevance and scope of accidental extracoronary findings in coronary computed tomography angiography: a cardiac versus thoracic FOV study. Eur J Radiol. 2010;74:166–74.PubMedCrossRef Aglan I, Jodocy D, Hiehs S, Soegner P, Frank R, Haberfellner B, et al. Clinical relevance and scope of accidental extracoronary findings in coronary computed tomography angiography: a cardiac versus thoracic FOV study. Eur J Radiol. 2010;74:166–74.PubMedCrossRef
11.
Zurück zum Zitat Mueller J, Jeudy J, Poston R, White CS. Cardiac CT angiography after coronary bypass surgery: prevalence of incidental findings. AJR Am J Roentgenol. 2007;189:414–9.PubMedCrossRef Mueller J, Jeudy J, Poston R, White CS. Cardiac CT angiography after coronary bypass surgery: prevalence of incidental findings. AJR Am J Roentgenol. 2007;189:414–9.PubMedCrossRef
12.
Zurück zum Zitat Jacobs PC, Mali WP, Grobbee DE, van der Graaf Y. Prevalence of incidental findings in computed tomographic screening of the chest: a systematic review. J Comput Assist Tomogr. 2008;32:214–21.PubMedCrossRef Jacobs PC, Mali WP, Grobbee DE, van der Graaf Y. Prevalence of incidental findings in computed tomographic screening of the chest: a systematic review. J Comput Assist Tomogr. 2008;32:214–21.PubMedCrossRef
13.
Zurück zum Zitat Horton KM, Post WS, Blumenthal RS, Fishman EK. Prevalence of significant noncardiac findings on electron-beam computed tomography coronary artery calcium screening examinations. Circulation. 2002;106:532–4.PubMedCrossRef Horton KM, Post WS, Blumenthal RS, Fishman EK. Prevalence of significant noncardiac findings on electron-beam computed tomography coronary artery calcium screening examinations. Circulation. 2002;106:532–4.PubMedCrossRef
14.
Zurück zum Zitat Hunold P, Schmermund A, Seibel RM, Grönemeyer DH, Erbel R. Prevalence and clinical significance of accidental findings in electron-beam tomographic scans for coronary artery calcification. Eur Heart J. 2001;22:1748–58.PubMedCrossRef Hunold P, Schmermund A, Seibel RM, Grönemeyer DH, Erbel R. Prevalence and clinical significance of accidental findings in electron-beam tomographic scans for coronary artery calcification. Eur Heart J. 2001;22:1748–58.PubMedCrossRef
15.
Zurück zum Zitat Onuma Y, Tanabe K, Nakazawa G, Aoki J, Nakajima H, Ibukuro K, et al. Noncardiac findings in cardiac imaging with multidetector computed tomography. J Am Coll Cardiol. 2006;48:402–6.PubMedCrossRef Onuma Y, Tanabe K, Nakazawa G, Aoki J, Nakajima H, Ibukuro K, et al. Noncardiac findings in cardiac imaging with multidetector computed tomography. J Am Coll Cardiol. 2006;48:402–6.PubMedCrossRef
16.
Zurück zum Zitat Haller S, Kaiser C, Buser P, Bongartz G, Bremerich J. Coronary artery imaging with contrast-enhanced MDCT: extracardiac findings. AJR Am J Roentgenol. 2006;187:105–10.PubMedCrossRef Haller S, Kaiser C, Buser P, Bongartz G, Bremerich J. Coronary artery imaging with contrast-enhanced MDCT: extracardiac findings. AJR Am J Roentgenol. 2006;187:105–10.PubMedCrossRef
17.
Zurück zum Zitat Vogel-Claussen J, Li D, Carr J, Liu K, Szklo M, Lima JA, et al. Extracoronary abnormalities on coronary magnetic resonance angiography in the multiethnic study of atherosclerosis study: frequency and clinical significance. J Comput Assist Tomogr. 2009;33:752–4.PubMedCentralPubMedCrossRef Vogel-Claussen J, Li D, Carr J, Liu K, Szklo M, Lima JA, et al. Extracoronary abnormalities on coronary magnetic resonance angiography in the multiethnic study of atherosclerosis study: frequency and clinical significance. J Comput Assist Tomogr. 2009;33:752–4.PubMedCentralPubMedCrossRef
18.
Zurück zum Zitat Budoff MJ, Fischer H, Gopal A. Incidental findings with cardiac CT evaluation: should we read beyond the heart? Catheter Cardiovasc Interv. 2006;68:965–73.PubMedCrossRef Budoff MJ, Fischer H, Gopal A. Incidental findings with cardiac CT evaluation: should we read beyond the heart? Catheter Cardiovasc Interv. 2006;68:965–73.PubMedCrossRef
19.
Zurück zum Zitat Knickelbine T, Lesser JR, Haas TS, Brandenburg ER, Gleason-Han BK, Flygenring B, et al. Identification of unexpected nonatherosclerotic cardiovascular disease with coronary CT angiography. JACC Cardiovasc Imaging. 2009;2:1085–92.PubMedCrossRef Knickelbine T, Lesser JR, Haas TS, Brandenburg ER, Gleason-Han BK, Flygenring B, et al. Identification of unexpected nonatherosclerotic cardiovascular disease with coronary CT angiography. JACC Cardiovasc Imaging. 2009;2:1085–92.PubMedCrossRef
20.
Zurück zum Zitat Taylor AJ, Cerqueira M, Hodgson JM, Mark D, Min J, O’Gara P, et al. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance. J Am Coll Cardiol. 2010;56:1864–94.PubMedCrossRef Taylor AJ, Cerqueira M, Hodgson JM, Mark D, Min J, O’Gara P, et al. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance. J Am Coll Cardiol. 2010;56:1864–94.PubMedCrossRef
Metadaten
Titel
The prevalence and clinical importance of incidentally detected noncoronary cardiovascular findings with coronary multidetector CT angiography
verfasst von
Cengiz Erol, MD
Mustafa Koplay, MD
Mehmet Şeker, MD
Yahya Paksoy, MD
Publikationsdatum
01.08.2014
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 15-16/2014
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-014-0556-y

Weitere Artikel der Ausgabe 15-16/2014

Wiener klinische Wochenschrift 15-16/2014 Zur Ausgabe

mitteilungen der gesellschaft der ärzte in wien

BILLROTHHAUS.TV