Prevalence and Significance of Incidental Extracardiac Findings of a Cardiac CT Angiography

Abstract

Background and objective: To evaluate prevalence and significance of extracardiac findings (ECF) in patients referred for cardiac CT angiography (CCTA). CCTA has the ability to depict ECF in the visualized thorax and upper abdomen. These incidental lesions can often present a challenge to physicians.

Method: We performed a retrospective review of 233 consecutive patients referred for CCTA. Extracardiac CT findings (ECF) were classified as benign, indeterminate, or of clinical significance at the time of image evaluation. Benign findings were those considered to be of little clinical significance with no follow-up needed. Indeterminate findings were those deemed of potential clinical importance, requiring correlation of the patient history or a follow-up study. Clinically significant findings were those felt to be of definite clinical importance requiring immediate evaluation or intervention.

Results: A total of 261 ECF were found in 153 patients (66%), 102males and 51 females, with a mean age of 67.2±12.5 years. Of those, 185 (71%) were considered benign, 37 (14%) indeterminate, and 39 clinically significant findings (15%). A total of 185 benign ECF were found in 115 patients. The 37 ECF indeterminate findings were present, distributed in 26 patients. The 39 clinically significant ECF were distributed in 38 patients.

Conclusion: There were a significant number of extracardiac findings in CCTA. Physicians who analyze CCTA should carefully evaluate all organs in the scan.

Keywords: Extracardiac findings, incidental findings, cardiac CTA, multidetector computed tomography (MDCT)