Keywords:
Cardiac, Cardiovascular system, CT, Observer performance, Education, Education and training
Authors:
J. Todd, M. Arzanauskaite; Liverpool/UK
DOI:
10.26044/esti2019/P-0061
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 of thoracic disorders and cardiac patients can often present atypically; for example,
with dyspnoea or epigastric pain,
which may lead to CT investigation that is not cardiac dedicated,
such as a CTPA for shortness of breath or CT abdomen,
for potential perforated viscous.
Historically,
evaluation of the heart on such studies is usually limited by motion artefact.
However,
with the use of multidetector CT technologies,
cardiac motion artefact is often reduced even without the use of ECG gated scanning allowing interpretation of cardiac findings possible.
It has been reported in the literature that the heart and great vessels are often neglected as a review area by general radiologists when reporting non-cardiac dedicated CT chest.
One paper describes 69% of detectable incidental cardiac findings were not reported in non-cardiac dedicated chest CT.
1
This pictorial review aims to give an overview of incidental cardiac findings that carry clinical significance and therefore may potentially alter patient management,
further investigation or diagnosis.