Type:
Educational Exhibit
Keywords:
Cardiac, CT, Diagnostic procedure, Education and training, Not applicable
Authors:
E. Pinto1, D. Penha1, S. Srivastava1, M. Ntouskou1, C. Monaghan1, M. D. McCreavy1, L. Taborda-Barata2, E. Marchiori3, K. L. Irion4; 1Liverpool/UK, 2Covilhã/PT, 3Rio de Janeiro/BR, 4Manchester/UK
DOI:
10.26044/ecr2020/C-09116
Background
Cardiac computed tomography (CT) has emerged as a useful non-invasive imaging modality.
There is established relevance in the evaluation of coronary artery disease in low and intermediate pre-test risk patients and pre-procedural planning for transcatheter interventions.
Cardiac CT evaluation entails special reconstruction settings and a dedicated cardiac FOV. For many imaging readers, this may mean that the remaining chest organs are excluded from the field of view which is not correct.
A systematic review found a median ECF occurrence of 45% in cardiac CT and around 16% are considered major findings with impact in patient prognosis.
Pulmonary nodules were among
the most common findings, occurring in 5%–20% of scans. Most of these nodules were small. Nodules greater than 1 cm were found in 0.9%–2% of patients.
Additional potentially important findings have included pulmonary embolism, aortic disease, lymphadenopathy, and upper abdominal abnormalities.
The detection of additional findings may also lead to earlier treatment for serious disease but may also result in unnecessary, costly, and occasionally harmful evaluations for findings that prove
ultimately to be benign.
However, if an abnormality is partially visualized at the periphery of a cardiac CT image, it is mandatory to further investigate this at the time of the study or with a directed follow-up examination as would be appropriate for other parts of the body
where a limited FOV is also used.