Staab Wieland, Bergau Leonard, Lotz Joachim, Sohns Christian
Institute for Diagnostic and Interventional Radiology, Heart Center, University Medical Center Göttingen, Robert-Koch-Str. 40, 37099 Göttingen, Germany; DZHK, German Center for Heart Research, Göttingen, Germany.
DZHK, German Center for Heart Research, Göttingen, Germany; Department of Cardiology and Pneumology, Heart Center, University Medical Center Göttingen, Göttingen, Germany.
J Cardiovasc Comput Tomogr. 2014 May-Jun;8(3):222-9. doi: 10.1016/j.jcct.2014.03.004. Epub 2014 Apr 25.
This study sought to determine the prevalence of significant and nonsignificant noncardiac findings in patients undergoing preprocedural dual-source CT (DSCT) before transcatheter aortic valve implantation (TAVI).
Patients (n = 204; aged, 80.5 ± 5.1 years; 106 men) underwent preprocedural DSCT of the thoracoabdominal aorta and the pelvic arterial vessels. Noncardiac findings were recorded and categorized as nonsignificant (group A), incidental findings requiring follow-up examinations (group B), and significant findings with a demand for clinical treatment (group C).
In 60 of 204 DSCT examinations (29.4%) no noncardiac findings were observed. Of the remaining 144 examinations (70.6%), 260 had noncardiac findings; 35 of 204 patients (17.1%) had a total of 37 clinically significant noncardiac findings. Eight malignancies were detected; 5 of them were incidentally diagnosed on DSCT and changed patient management. A total of 223 nonsignificant findings were observed in 116 of 204 patients (56.9%; group A), the most frequent findings were pleural effusions or colorectal diverticulosis. The prevalence of incidental and significant findings on DSCT before TAVI increased with patient age (r(2) = 0.69; P = .01).
Significant noncardiac findings are common in patients referred to routine preprocedural DSCT for planning TAVI (17.1%).
本研究旨在确定经导管主动脉瓣植入术（TAVI）术前接受双源CT（DSCT）检查的患者中，显著和非显著非心脏检查结果的发生率。
患者（n = 204；年龄80.5±5.1岁；男性106例）在术前接受胸主动脉、腹主动脉及盆腔动脉血管的DSCT检查。记录非心脏检查结果并分为非显著（A组）、需要随访检查的偶然发现（B组）以及需要临床治疗的显著发现（C组）。
204例DSCT检查中，60例（29.4%）未观察到非心脏检查结果。其余144例检查（70.6%）中，260例有非心脏检查结果；204例患者中有35例（17.1%）共有37项具有临床意义的非心脏检查结果。检测到8例恶性肿瘤；其中5例在DSCT检查时偶然诊断出，改变了患者的治疗方案。204例患者中有116例（56.9%；A组）共观察到223项非显著检查结果，最常见的是胸腔积液或结肠憩室。TAVI术前DSCT偶然发现和显著发现的发生率随患者年龄增加而升高（r(2)=0.69；P = 0.01）。
在因TAVI计划而接受常规术前DSCT检查的患者中，显著非心脏检查结果很常见（17.1%）。
