Learning objectives
· To inform the chest and general radiologist of important incidental cardiac findings in non-cardiac dedicated CT.
· To provide a pictorial review of various incidental cardiac findings that may influence patient management.
Background
An incidental finding or 'incidentaloma' can be described as a lesion that is serendipitously noted during computed tomography (CT) magnetic resonance (MRI) or ultrasound (USS) imaging that were performed for other reasons.
Often indidentalomas can be disregarded as benign or of no clinical significance,
however there are a number of cardiac findings that we believe should trigger further investigation or may alter patient management and should therefore be borne in mind when reporting CT chest.
Non-cardiac dedicated CT chest has a crucial role in diagnosis...
Imaging findings OR procedure details
Evaluation of the heart in a non-cardiac gated study is often limited due to motion artefact; however,
there are numerous important cardiac conditions that are crucial to be able to identify to guide appropriate further investigation and treatment.
Examples include but are not limited to the following: coronary artery disease,
myocardial infarction,
right ventricular thrombus,
cardiac metastasis,
displaced sternotomy wire,
and pericardial effusion.
Pericardium:
– Calcification and pericarditis
– Effusion
– Malignancy,
such as nodularity in mesothelioma
Pericardial calcification.
This patient had a known history...
Conclusion
This pictorial review illustrates several incidental cardiac findings that we feel the general and chest radiologist should be able to identify and describe in a non-cardiac dedicated CT study. Not only are there potential for severe clinical consequences if missed or not documented,
clinical management and patient prognosis may also be altered.
References
1.
Mathewson FA.
Calcification of the pericardium in apparently healthy people; electrocardiographic abnormalities found in tracings from apparently healthy persons with calcification of the pericardium.
Circulation 1955; 12: 44-51.
Isaacs D,
Stark P,
Nichols C,
Antevil J,
Shabetai R.
Posttraumatic pericardial calcification.
J Thorac Imaging 2003; 18: 250-253
Sengupta PP,
Eleid MF,
Khandheria BK.
Constrictive pericarditis.
Circ J 2008; 72: 1555-1562
Ferguson EC,
Berkowitz EA.
Cardiac and pericardial calcifications on chest radiographs.
Clin Radiol 2010; 65: 685-694
Massimo Imazio,
Yehuda Adler; Management of pericardial effusion,European...