Skip to main content
Log in

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

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

Purpose To compare the prevalence and clinical significance of incidental extracardiac findings at cardiac CT angiography (CCTA) with precontrast low-dose whole thoracic scan (LDCT) and ECG-gated CCTA. Materials and Methods We reviewed 254 patients who underwent CCTA. All participants first underwent LDCT to determine a range for CCTA and to screen unrecognized extracardiac lesions. CCTA was reconstructed with a small field of view of the heart. Clinically significant extracardiac findings were defined as abnormalities requiring further diagnostic work up, therapeutic intervention, or follow-up. Results On LDCT, 285 extracardiac findings were detected in 62.6% patients; on CCTA, 18 findings in 7% patients. Among these, 66 findings in 20.4% patients were considered clinically significant on LDCT, and 4 findings in 1.6% patients on CCTA. Conclusion Clinically significant extracardiac findings are common in patients undergoing CCTA with a considerable number of extracardiac findings being detected only on LDCT. We advise performing whole thorax LDCT prior to CCTA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Nieman K, Cademartiri F, Lemos PA et al (2002) Reliable noninvasive coronary angiography with fast submillimeter multislice spiral computed tomography. Circulation 106(16):2051–2054. doi:10.1161/01.CIR.0000037222.58317.3D

    Article  PubMed  Google Scholar 

  2. Leber AW, Knez A, von Ziegler F et al (2005) Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography: a comparative study with quantitative coronary angiography and intravascular ultrasound. J Am Coll Cardiol 46(1):147–154. doi:10.1016/j.jacc.2005.03.071

    Article  PubMed  Google Scholar 

  3. Raff GL, Gallagher MJ, O’Neill WW et al (2005) Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J Am Coll Cardiol 46(3):552–557. doi:10.1016/j.jacc.2005.05.056

    Article  PubMed  Google Scholar 

  4. Haller S, Kaiser C, Buser P et al (2006) Coronary artery imaging with contrast-enhanced MDCT: extracardiac findings. AJR Am J Roentgenol 187(1):105–110. doi:10.2214/AJR.04.1988

    Article  PubMed  Google Scholar 

  5. Northam M, Koonce J, Ravenel JG (2008) Pulmonary nodules detected at cardiac CT: comparison of images in limited and full fields of view. AJR Am J Roentgenol 191(3):878–881. doi:10.2214/AJR.07.2939

    Article  PubMed  Google Scholar 

  6. Hunold P, Schmermund A, Seibel RM et al (2001) Prevalence and clinical significance of accidental findings in electron-beam tomographic scans for coronary artery calcification. Eur Heart J 22(18):1748–1758. doi:10.1053/euhj.2000.2586

    Article  PubMed  CAS  Google Scholar 

  7. Burt JR, Iribarren C, Fair JM et al (2008) Incidental findings on cardiac multidetector row computed tomography among healthy older adults: prevalence and clinical correlates. Arch Intern Med 168(7):756–761. doi:10.1001/archinte.168.7.756

    Article  PubMed  Google Scholar 

  8. Kawano Y, Tamura A, Goto Y et al (2007) Incidental detection of cancers and other noncardiac abnormalities on coronary multislice computed tomography. Am J Cardiol 99(11):1608–1609. doi:10.1016/j.amjcard.2007.01.038

    Article  PubMed  Google Scholar 

  9. Mueller J, Jeudy J, Poston R et al (2007) Cardiac CT angiography after coronary bypass surgery: prevalence of incidental findings. AJR Am J Roentgenol 189(2):414–419. doi:10.2214/AJR.06.0736

    Article  PubMed  Google Scholar 

  10. Gil BN, Ran K, Tamar G et al (2007) Prevalence of significant noncardiac findings on coronary multidetector computed tomography angiography in asymptomatic patients. J Comput Assist Tomogr 31(1):1–4. doi:10.1097/01.rct.0000233125.83184.33

    Article  PubMed  Google Scholar 

  11. Dewey M, Schnapauff D, Teige F et al (2007) Noncardiac findings on coronary computed tomography and magnetic resonance imaging. Eur Radiol 17(8):2038–2043. doi:10.1007/s00330-006-0570-1

    Article  PubMed  Google Scholar 

  12. Kirsch J, Araoz PA, Steinberg FB et al (2007) Prevalence and significance of incidental extracardiac findings at 64-multidetector coronary CTA. J Thorac Imaging 22(4):330–334

    Article  PubMed  Google Scholar 

  13. Onuma Y, Tanabe K, Nakazawa G et al (2006) Noncardiac findings in cardiac imaging with multidetector computed tomography. J Am Coll Cardiol 48(2):402–406. doi:10.1016/j.jacc.2006.04.071

    Article  PubMed  Google Scholar 

  14. Horton KM, Post WS, Blumenthal RS et al (2002) Prevalence of significant noncardiac findings on electron-beam computed tomography coronary artery calcium screening examinations. Circulation 106(5):532–534. doi:10.1161/01.CIR.0000027136.56615.DE

    Article  PubMed  Google Scholar 

  15. Law YM, Huang J, Chen K et al (2008) Prevalence of significant extracoronary findings on multislice CT coronary angiography examinations and coronary artery calcium scoring examinations. J Med Imaging Radiat Oncol 52(1):49–56. doi:10.1111/j.1440-1673.2007.01911.x

    Article  PubMed  CAS  Google Scholar 

  16. Budoff MJ, Fischer H, Gopal A (2006) Incidental findings with cardiac CT evaluation: should we read beyond the heart? Catheter Cardiovasc Interv 68(6):965–973. doi:10.1002/ccd.20924

    Article  PubMed  Google Scholar 

  17. Kim SM, Chung MJ, Lee KS et al (2008) Coronary calcium screening using low-dose lung cancer screening: effectiveness of MDCT with retrospective reconstruction. AJR Am J Roentgenol 190(4):917–922. doi:10.2214/AJR.07.2979

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eun-Young Kang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, J.W., Kang, EY., Yong, H.S. 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 25 (Suppl 1), 75–81 (2009). https://doi.org/10.1007/s10554-008-9417-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-008-9417-y

Keywords

Navigation