Apter Sara, Amir Gabriel, Taler Michael, Gayer Gabriela, Kuriansky Joseph, Amitai Michal, Smolinsky Aram Kurtz, Hertz Marjorie
Department of Diagnostic Imaging, Sheba Medical Center, Sackler School of Medicine, University of Tel Aviv, Tel Aviv, Israel.
Clin Radiol. 2002 Apr;57(4):287-91. doi: 10.1053/crad.2001.0798.
to draw the attention to upper abdominal abnormalities, which may be revealed incidentally in patients referred for a chest computed tomography (CT) after cardiac surgery.
We reviewed prospectively and retrospectively the CT results of all patients referred for a chest CT, with suspected sternal infection or for other reasons, after cardiac surgery, to assess possible upper abdominal disease as visualized on lower cuts of the chest CT with abdominal windows.
Out of a total of 205 patients in the study 39 (19%) had unexpected abdominal abnormalities. The organs involved in decreasing order of frequency were the spleen (n = 18), gallbladder (n = 15), pancreas (n = 9), kidneys (n = 6) and bowel (n = 3). Many patients had involvement of more than one organ. The lesions were mainly ischaemic and/or infectious in origin. These findings led to interventional procedures in 13 (33%) of the patients with a good outcome.
We found a relatively high prevalence of abdominal abnormalities on CT of the chest in patients referred with suspected thoracic problems after cardiac surgery. Major findings on CT led to changes in the management of these patients. We recommend therefore viewing lung bases with abdominal windows as well as adding sections through the upper abdomen in patients who are referred for a chest CT after cardiac surgery with suspected thoracic problems.
引起对心脏手术后因胸部计算机断层扫描（CT）而转诊的患者中可能偶然发现的上腹部异常情况的关注。
我们前瞻性和回顾性地分析了所有因疑似胸骨感染或其他原因在心脏手术后接受胸部CT检查的患者的CT结果，以评估在采用腹部窗宽的胸部CT下部层面上可见的可能的上腹部疾病。
在该研究的205例患者中，39例（19%）有意外的腹部异常。受累器官按出现频率从高到低依次为脾脏（n = 18）、胆囊（n = 15）、胰腺（n = 9）、肾脏（n = 6）和肠道（n = 3）。许多患者有多个器官受累。这些病变主要起源于缺血和/或感染。这些发现导致13例（33%）患者接受了介入治疗，且预后良好。
我们发现，心脏手术后因疑似胸部问题而转诊的患者中，胸部CT显示腹部异常的发生率相对较高。CT上的主要发现导致了这些患者治疗方案的改变。因此，我们建议，对于心脏手术后因疑似胸部问题而接受胸部CT检查的患者，采用腹部窗宽观察肺底部，并增加上腹部层面扫描。
