Korean Circ J.  2008 May;38(5):276-283. 10.4070/kcj.2008.38.5.276.

Non-cardiac Findings on 64-Slice Cardiac Multi-detector CT

• Yoon YE
• Chun EJ
• Choi EK
• Cho Y
• Lee W
• Choi SI
• Choi DJ
• Chang HJ

• KMID: 2225790
• DOI: http://doi.org/10.4070/kcj.2008.38.5.276

Abstract

BACKGROUND AND OBJECTIVES: Multi-detector CT (MDCT) is becoming more commonly used as a diagnostic tool for various cardiac diseases, and this modality can also incidentally detect a significant number of non-cardiac findings during cardiac work-ups. The objectives of this study were to evaluate the incidence of non-cardiac findings during cardiac MDCT and to compare them with chest CT.
SUBJECTS AND METHODS
We enrolled 1,007 consecutive subjects (mean age: 49+/-10 years, males: 63%) who underwent both cardiac and chest CT (64-slice MDCT) as a part of a routine health check-up. The subjects were evaluated for the incidence of non-cardiac findings and the therapeutic consequences according to the CT protocols during the mid-term follow-up (average length of mid-term follow-up: 533+/-39 days).
RESULTS
Eight hundred sixty incidental non-cardiac findings were identified in 627 patients (62%) with cardiac CT. Forty-three subjects (4%) had clinically significant lesions that required additional diagnostic work-up or radiological follow-up, and these lesions were 23 cases of non-calcified nodule, 2 cases of ground glass opacity, 6 cases of pneumonia, 1 case of active tuberculosis, 2 cases of focal bronchiolitis, 3 cases of arterial lesion, 1 case of liver cirrhosis and 5 cases of extra-pulmonary masses. Five subjects (0.5%), including 2 cases (0.2%) of malignancy, had therapeutic consequences during their follow-up. Compared with chest CT, 68% (40/59) of the significant intrathoracic lesions and 67% (4/6) of the intrathoracic lesions with therapeutic consequences were documented by cardiac CT.
CONCLUSION
In the present study, 4% of the asymptomatic patients who underwent cardiac MDCT were found to have significant non-cardiac findings that required further work-up. To avoid missing a number of clinically important findings, physicians who analyze cardiac MDCT scans should carefully evaluate not only the heart, but all the other organs that are within the scan range.

Keyword

Tomography, X-ray computed; Heart; Lung

MeSH Terms

Bronchiolitis
Follow-Up Studies
Glass
Heart
Heart Diseases
Humans
Incidence
Liver Cirrhosis
Lung
Pneumonia
Thorax
Tomography, X-Ray Computed
Tuberculosis

Figure

• 

  Fig. 1 Field of views (FOV) for the cardiac and chest CT. A: the view in box A is the limited field of view that is conventionally used for the reconstruction of cardiac MDCT. B: the view in box B is the entire scan range for cardiac MDCT, that is, the maximal field of view for cardiac MDCT. C: the view in box C is the scan range for chest CT. MDCT: multi-detector CT.

• 

  Fig. 2 Cases of significant non-cardiac findings on the maximal FOV of cardiac MDCT. A: a 53-year-old woman with mycobacteria other than tuberculosis (arrows). B: a 39-year-old woman with bronchiolitis obliterans organizing pneumonia (arrow). C: a 53-year-old man with thymic carcinoma that showed bone invasion (arrows) and metastatic spread to a lymph node (arrowhead). D: a 61-year-old man with hepatocellular carcinoma (arrow).

• 

  Fig. 3 Cardiac MDCT detection of non-cardiac findings on Chest CT (n=1007, per patient analysis). The graphic shows the proportion of non-cardiac findings detected on cardiac CT as compared with chest CT. A: overall lesions (n=1259). B: intrathoracic lesions (n=417).

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