Purpose
Computed Tomography (CT) of the thorax is a commonly used imaging modality to evaluate multiple different pulmonary pathologies.
Contrast enhanced (CE) and non-enhanced (NE) CT scanning protocols are used for different thoracic indications,
e.g.
staging of cancer,
interstitial lung disease,
infections,
and pulmonary embolism1-8.
Pulmonary pathologies often have an interaction with cardiovascular pathologies,
e.g.
the presence of coronary artery disease (CAD) in chronic obstructive pulmonary disease (COPD) increases morbidity and mortality and worsens prognosis.9 New technical developments make ultra-fast non-ECG triggered scan acquisition with a...
Methods and Materials
Between December 2015and March 2016,
100 consecutive patients referred for standard thoracic CT-scanning between December 2015 and March 2016 were included.
Scan protocol consisted of kVp settings between 70-120kV (CAREkV,
Siemens),
pitch value of 3,
reference tube current 40mAsref,
0.6mm slice thickness,
and 0.4mm increment,
on a 3rd-generation dual-source CT (Somatom Definition Force,
Siemens).
A dedicated cardiac post-processing reconstruction was added to standard reconstructions (Kernel Bv36).
Contrast Media (CM)Injection protocol consisted of 30mL CM; 25mL mixed (50/50),
and 20 mL NaCl.
Subjective image quality (SIQ)...
Results
Of all 100 scans,
79.5% had excellent-sufficient SIQ (see figure 1 and 2).
AVC (23.5%),
MVC (12.7%),
pericardial abnormality (4.8%) and CAD (69.3%) were present (see table 1).
Aortic valve morphology (99%) could be assessed on almost all CE scans.
CAD (15.1%) was not assessable in some cases due to movement artefacts or low enhancement.
Of all 1.700 reviewed coronary segments,
952 segments (56%) were assessable with regard to detection of CAD.
(see table 2).
Out of all segments on CE scans (n=100),
the distal...
Conclusion
A broad range of cardiac pathologies can be detected and evaluated on standard non-ECG triggered high-pitch thoracic CT-scans.
This should be taken into account during assessing and reporting on thoracic CT studies.
References
1. Kazerooni EA,
Austin JH,
Black WC,
et al.
ACR-STR practice parameter for the performance and reporting of lung cancer screening thoracic computed tomography (CT): 2014 (Resolution 4).
J Thorac Imaging 2014;29:310-6.
2. Remy-Jardin M,
Pistolesi M,
Goodman LR,
et al.
Management of Suspected Acute Pulmonary Embolism in the Era of CT Angiography: A Statement from the Fleischner Society.
Radiology 2007;245:315-29.
3. MacMahon H,
Austin JHM,
Gamsu G,
et al.
Guidelines for Management of Small Pulmonary Nodules Detected on CT Scans: A Statement from the...
