Prevalence and clinical significance of incidental extracardiac findings at cardiac CT angiography : Comparison between precontrast low-dose whole thoracic scan and postcontrast retrospective ECG-gated cardiac scan

다국어 초록 (Multilingual 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 retrospectively reviewed 254 consecutive patients (142 males, 112 females, mean age: 58.5 ± 13.1 years) who underwent cardiac CT angiography (CCTA). All participants were taken precontrast low-dose CT scan on whole thorax (LDCT) at first to decide the strict range of postcontrast retrospective ECG-gated CCTA and to screen the unrecognized extracardiac lesion. CCTA was reconstructed with small field of view (FOV) dedicated to the heart. Images of each scans were analyzed on a PACS workstation with various window settings. Extracardiac findings were divided into 2 categories according to clinical significance. 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 159 patients (159/254, 62.6%), and 18 findings in 18 patients on CCTA with small FOV. Among these, 66 findings in 52 patients (52/254, 20.4%) were considered clinically significant on LDCT and 4 findings in 4 patients were clinically significant on CCTA. Of the 52 patients who have significant findings on LDCT, abnormalities of 48 patients were not delineated on CCTA with small FOV, because the lesions were beyond the scan range.

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.

목차 (Table of Contents)

• Abstract i
• I. Introduction 1
• II. Materials and Methods 3
• III. Results 6
• IV. Discussion 8
• V. References 13