Purpose
The aim of this study was to assess the prevalence of reportable cardiac findings
detected on abdominopelvic CTs and the association with subsequent cardiovascular
events.
Materials and Methods
We performed a retrospective search of electronic medical record of patients who underwent
abdominopelvic CT between November 2006 and November 2011 with a clinical history
of upper abdominal pain. A radiologist blinded to the original CT report reviewed
all 222 cases for the presence of pertinent reportable cardiac findings. The original
CT report was also evaluated for documentation of pertinent reportable cardiac findings.
The following findings were recorded on all CTs: presence of coronary calcification,
fatty metaplasia, ventricle wall thinning and thickening, valve calcification or prosthesis,
heart/chamber enlargement, aneurysm, mass, thrombus, device, air within ventricles,
abnormal pericardium, prior sternotomy, and adhesions if prior sternotomy. Medical
records were reviewed to identify cardiovascular events on follow-up in patients with
the presence or absence of cardiac findings. We compared the distribution findings
in patients with and without cardiac events using the Wilcoxon test (for continuous
variables) and the Pearson's chi-squared test (for categorical variables).
Results
Eighty-five of 222 (38.3%) patients (52.7% females, median age 52.5 years) had at
least one pertinent reportable cardiac finding on the abdominopelvic CT, with a total
of 140 findings in this group. From the total 140 findings, 100 (71.4%) were not reported.
The most common findings seen on abdominal CTs were: coronary artery calcification
(66 patients), heart or chamber enlargement (25), valve abnormality (19), sternotomy
and surgery signs (9), LV wall thickening (7), device (5), LV wall thinning (2), pericardial
effusion (5), and others (3). After a mean follow-up of 43.9 months, 19 cardiovascular
events were found in the cohort (transient ischemic attack, cerebrovascular accident,
myocardial infarction, cardiac arrest, acute arrhythmia, palpitation, syncope and
acute chest pain). Only 1 event occurred in the group of patients with no incidental
pertinent reportable cardiac findings (1/137 = 0.73%). All other 18 events occurred
in patients with incidental pertinent reportable cardiac findings (18/85 = 21.2%),
which was significantly different (p < 0.0001). One out of the total 19 events in the overall group (5.24%) occurred in
a patient with no incidental pertinent reportable cardiac findings while 18 of 19
total events (94.74%) occurred with patients with incidental pertinent reportable
cardiac findings, which was also significantly different (p < 0.001). Fifteen of the total events (79%) occurred in patients in whom the incidental
pertinent reportable cardiac findings were not reported, which was significantly different
(p < 0.001) from the four events that occurred in patients in whom the incidental pertinent
reportable cardiac findings were reported or had no findings.
Conclusions
Incidental pertinent reportable cardiac findings are common on abdominal CTs and are
frequently not reported by radiologists. These findings are of clinical relevance
since patients with pertinent reportable cardiac findings have a significantly higher
incidence of cardiovascular events on follow-up.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Academic RadiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Incidental CT findings in trauma patients: incidence and implications for care of the injured.J Trauma. 2007; 62: 157-161
- Incidental findings in blunt trauma patients: prevalence, follow-up documentation, and risk factors.Emerg Radiol. 2017; 24: 347-353
- Incidental findings detected on emergency abdominal CT scans: a 1-year review.Abdom Imaging. 2015; 40: 1853-1857
- Prevalence of incidental findings on abdominal computed tomography angiograms on prospective renal donors.Transplantation. 2015; 99: 1203-1207
- Pertinent reportable incidental cardiac findings on chest CT without electrocardiography gating: review of 268 consecutive cases.Acta Radiol. 2013; 54: 396-400
- Incidental imaging findings from routine chest CT used to identify subjects at high risk of future cardiovascular events.Radiology. 2014; 272: 700-708
- Under-reporting of cardiovascular findings on chest CT.Radiol Med. 2016; 121: 190-199
- Incidental myocardial infarct on conventional nongated CT: a review of the spectrum of findings with gated CT and cardiac MRI correlation.AJR Am J Roentgenol. 2012; 198: 496-504
- Acute myocardial infarction and cardiac perforation on non-gated CT.Eur Heart J. 2006; 27: 129
- Comparison of ECG-gated versus non-gated CT ventricular measurements in thirty patients with acute pulmonary embolism.Int J Cardiovasc Imaging. 2009; 25: 101-107
- Features of cardiac disease demonstrated on CT pulmonary angiography.Clin Radiol. 2005; 60: 31-38
- Incidental cardiac and pericardial abnormalities on chest CT.J Thorac Imaging. 2008; 23: 216-226
- Cardiac and pericardial abnormalities on chest computed tomography: what can we see?.Radiol Med. 2010; 115: 175-190
- Should radiologists comment on incidental findings of vascular calcifications found on abdominal/pelvic CT in patients less than 50 years of age?.Acad Radiol. 2020; 27: 1057-1062
- Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017.Lancet. 2018; 392: 1736-1788
- Age-related incidence of pulmonary embolism and additional pathologic findings detected by computed tomography pulmonary angiography.Eur J Radiol. 2012; 81: 1913-1916
- Incidental cardiac findings in non-electrocardiogram-gated thoracic computed tomography of intensive care unit patients: assessment of prevalence and underreporting.J Thorac Imaging. 2018; 33: 168-175
- Detection of incidental cardiac findings in noncardiac chest computed tomography.Medicine (Baltimore). 2017; 96: e7531
- 2016 SCCT/STR guidelines for coronary artery calcium scoring of noncontrast noncardiac chest CT scans: a report of the Society of Cardiovascular Computed Tomography and Society of Thoracic Radiology.J Cardiovasc Comput Tomogr. 2017; 11: 74-84
- Relationships of mitral annular calcification to cardiovascular risk factors: the Multi-Ethnic Study of Atherosclerosis (MESA).Atherosclerosis. 2010; 213: 558-562
- Mitral annular calcifications and aortic plaques as predictors of increased cardiovascular mortality.J Cardiol. 2001; 37: 21-26
- Vascular calcifications as a marker of increased cardiovascular risk: a meta-analysis.Vasc Health Risk Manag. 2009; 5: 185-197
- The role of standard non-ECG gated chest CT in cardiac assessment: design and rationale of the Cardiac Pathologies in standard chest CT (CaPaCT) study.Eur Radiol Exp. 2018; 2: 9
Article info
Publication history
Published online: March 03, 2023
Accepted:
January 21,
2023
Received in revised form:
January 20,
2023
Received:
October 31,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
