Department of Radiology, Medical School of Thessaly, Mezourlo, Larissa 41110, Greece.
Korean J Radiol. 2010 Jan-Feb;11(1):60-8. doi: 10.3348/kjr.2010.11.1.60. Epub 2009 Dec 28.
To evaluate the spectrum, prevalence, and significance of incidental non-cardiac findings (INCF) in patients referred for a non-invasive coronary angiography using a 128-slice multi-detector CT (MDCT).
The study subjects included 1,044 patients; 774 males (mean age, 59.9 years) and 270 females (mean age, 63 years), referred for a coronary CT angiography on a 128-slice MDCT scanner. The scans were acquired from the level of the carina to just below the diaphragm. To evaluate INCFs, images were reconstructed with a large field of view (> 300 mm) covering the entire thorax. Images were reviewed in the axial, coronal, and sagittal planes, using the mediastinal, lung, and bone windows. The INCFs were classified as severe, indeterminate, and mild, based on their clinical importance, and as thoracic or abdominal based on their locations.
Incidental non-cardiac findings were detected in 56% of patients (588 of 1,044), including 435 males (mean age, 65.6 years) and 153 females (mean age, 67.9 years). A total of 729 INCFs were observed: 459 (63%) mild (58% thoracic, 43% abdominal), 96 (13%) indeterminate (95% thoracic, 5% abdominal), and 174 (24%) severe (87% thoracic, 13% abdominal). The prevalence of severe INCFs was 15%. Two severe INCFs were histologically verified as lung cancers.
The 128-slice MDCT coronary angiography, in addition to cardiac imaging, can provide important information on the pathology of the chest and upper abdomen. The presence of severe INCFs is not rare, especially in the thorax. Therefore, all organs in the scan should be thoroughly evaluated in daily clinical practice.
评估使用 128 层多探测器 CT（MDCT）进行非侵入性冠状动脉造影检查的患者中偶然的非心脏发现（INCF）的谱、患病率和意义。
研究对象包括 1044 名患者；774 名男性（平均年龄 59.9 岁）和 270 名女性（平均年龄 63 岁），因冠状动脉 CT 血管造影而在 128 层 MDCT 扫描仪上接受检查。扫描范围从隆突到膈肌以下。为了评估 INCF，使用大视野（>300mm）重建图像，覆盖整个胸部。在轴位、冠状位和矢状位平面上，使用纵隔、肺和骨窗对图像进行了评估。根据其临床重要性，将 INCF 分为严重、不确定和轻度，并根据其位置分为胸部或腹部。
在 56%的患者（1044 名患者中的 588 名）中发现了偶然的非心脏发现，包括 435 名男性（平均年龄 65.6 岁）和 153 名女性（平均年龄 67.9 岁）。共观察到 729 例 INCF：459 例（63%）轻度（58%胸部，43%腹部），96 例（13%）不确定（95%胸部，5%腹部）和 174 例（24%）严重（87%胸部，13%腹部）。严重 INCF 的患病率为 15%。2 例严重 INCF 经组织学证实为肺癌。
128 层 MDCT 冠状动脉造影术除了心脏成像外，还可以提供有关胸部和上腹部病理学的重要信息。严重 INCF 的存在并不罕见，尤其是在胸部。因此，在日常临床实践中，应彻底评估扫描中的所有器官。
