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

Prävalenz und klinische Bedeutung von mittels koronarer Multidetektor CT-Angiographie zufällig entdeckten nicht-koronaren kardiovaskulären Befunden

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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.

Zusammenfassung

Ziel

der Studie war es, die Prävalenz und klinische Bedeutung von zufällig erhobenen Befunden nicht-koronarer kardialer Strukturen und mediastinaler großer Gefäße bei Patienten zu erheben, bei denen eine Koronare Computertomographische Angiographie (KCTA) durchgeführt worden war.

Methodik

Die Studie schloss 2096 konsekutive Patienten (1472 Männer und 624 Frauen – mittleres Alter: 55 Jahre) ein. Die kardiovaskulären Befunde wurden in 3 Gruppen entsprechend ihrer klinischer Bedeutung eingeteilt: Gruppe 1: der Befund machte eine sofortige Behandlung oder Intervention notwendig. Gruppe 2: die Befunde gaben Anlass zu klinischer Achtsamkeit, Kontrolle und/oder weiteren klinischen und/oder radiologischen Untersuchungen. Gruppe 3: die Befunde erforderten keine Kontrollen oder weitere Untersuchungen. Wir untersuchten auch, ob die erhobenen kardiovaskulären Diagnosen vor der Untersuchung schon bekannt waren.

Ergebnisse

Insgesamt wurden 174 Anomalitäten (8,3 %) bei 170 Patienten entdeckt. 21 Befunde (12 %) wurden als der Gruppe 1 zugehörig eingestuft, 121 Befunde (69,5 %) der Gruppe 2 und 32 Befunde (18,5 %) der Gruppe 3. Der Großteil der kardiovaskulären Befunde (140/174; 80,5 %) waren vor der KCTA nicht bekannt und wurden daher als Zufallsbefunde gewertet.

Schlussfolgerungen

Nicht koronare kardiovaskuläre abnorme Befunde sind bei Patienten, bei denen eine KCTA durchgeführt wird, häufig. Es ist wichtig, diese Ergebnisse zu kennen, da solche Befunde eine sofortige Behandlung oder Intervention benötigen können. Bei der Befundung sollten daher alle dargestellten kardiale Strukturen mit großer Achtsamkeit betrachtet werden.

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The authors declare that there is no conflict of interest and financial relationship.

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey

    Cengiz Erol MD & Yahya Paksoy MD

  2. Department of Radiology, Medical Faculty of Selcuk University, The Central Campus, 42100, Konya, Turkey

    Mustafa Koplay MD

  3. Department of Radiology, TDV 29 May Hospital, Istanbul, Turkey

    Mehmet Şeker MD

Authors
  1. Cengiz Erol MD
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  2. Mustafa Koplay MD
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  3. Mehmet Şeker MD
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  4. Yahya Paksoy MD
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Correspondence to Mustafa Koplay MD.

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Erol, C., Koplay, M., Şeker, M. et al. The prevalence and clinical importance of incidentally detected noncoronary cardiovascular findings with coronary multidetector CT angiography. Wien Klin Wochenschr 126, 460–467 (2014). https://doi.org/10.1007/s00508-014-0556-y

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  • DOI: https://doi.org/10.1007/s00508-014-0556-y

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