Kirsch Jacobo, Araoz Philip A, Steinberg Frederick B, Fletcher Joel G, McCollough Cynthia H, Williamson Eric E
Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
J Thorac Imaging. 2007 Nov;22(4):330-4. doi: 10.1097/RTI.0b013e31813434a9.
Computed tomography (CT) angiography of the coronaries has the ability to depict extracardiac lesions in the visualized thorax and upper abdomen. These incidental lesions can often present a challenge to physicians.
We performed a retrospective review of 100 consecutive patients referred for 64-multidetector CT coronary CT angiography performed on a 64-slice CT scanner. Two fellowship trained cardiac radiologists reviewed each study by consensus on a CT postprocessing workstation using commercially available software. 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.
The study cohort consisted of 68 males (68%) and 32 females (32%) with a mean (+/-standard deviation) age of 63.4+/-14.5 years and a range of 23 to 87 years. A total of 145 ECF were found in 67 patients (67%), 50 males and 17 females, with a mean age of 68.0+/-11.8 years and a range of 23 to 87 years. Of those, 107 (73.8%) were considered benign, 22 (15.2%) indeterminate, and 16 clinically significant findings (11.0%). By significance, a total of 107 benign ECF were found in 61 patients, 46 males and 15 females, with a mean age of 67.7+/-12.2 years and a range of 23 to 87 years. Only 22 ECF indeterminate findings were present, distributed in 21 patients, of which there were 17 males and 5 females, with a mean age of 68.5+/-13.9 and a range of 23 to 82 years. The 16 clinically significant ECF were distributed in 11 patients, all males, with a mean age of 68.0+/-8.8 and a range of 55 to 87 years.
The presence of ECF in our daily practice is frequent, and not limited to the identification of pulmonary nodules, and reinforces the notion that all the organs in the scan should be thoroughly and methodically evaluated.
冠状动脉计算机断层扫描（CT）血管造影能够显示可视化胸部和上腹部的心脏外病变。这些偶然发现的病变常常给医生带来挑战。
我们对连续100例因64层CT扫描仪进行64排CT冠状动脉CT血管造影而转诊的患者进行了回顾性研究。两位经过专科培训的心脏放射科医生在CT后处理工作站上使用商用软件通过共识对每项研究进行了评估。在图像评估时，将心脏外CT表现（ECF）分为良性、不确定或具有临床意义。良性表现是那些被认为临床意义不大且无需随访的表现。不确定表现是那些被认为具有潜在临床重要性的表现，需要结合患者病史或进行随访研究。具有临床意义的表现是那些被认为具有明确临床重要性、需要立即评估或干预的表现。
研究队列包括68名男性（68%）和32名女性（32%），平均（±标准差）年龄为63.4±14.5岁，年龄范围为23至87岁。在67例患者（67%）中总共发现了145个ECF，其中男性50例，女性17例，平均年龄为68.0±11.8岁，年龄范围为23至87岁。其中，107个（73.8%）被认为是良性的，22个（15.2%）不确定，16个具有临床意义（11.0%）。按重要性划分，在61例患者中总共发现了107个良性ECF，其中男性46例，女性15例，平均年龄为67.7±12.2岁，年龄范围为23至87岁。仅存在22个ECF不确定表现，分布在21例患者中，其中男性17例，女性5例，平均年龄为68.5±13.9岁，年龄范围为23至82岁。16个具有临床意义的ECF分布在11例患者中，均为男性，平均年龄为68.0±8.8岁，年龄范围为55至87岁。
在我们的日常实践中，ECF的存在很常见，且不限于肺结节的识别，并强化了扫描中的所有器官都应进行全面且系统评估的观念。
