What non-coronary incidental findings can a radiologist detect in an ECG-gated computed tomography scan?

Introduction
Cardiac ECG-CT is the standard method of assessing atherosclerotic lesions of the coronary arteries. Radiologist should always evaluate all structures included in the study. Changes found during this “additional” assessment may have great importance in further diagnostic and therapeutic procedures.

Aim of the research
To analyse the significance of all extracoronary findings detected in 230 multi-slice cardiac tomography examinations.

Material and methods
The study retrospectively evaluated the results of 230 examinations of patients referred for ECG-CT. The study group consisted of 122 (53.0%) men and 108 (47.0%) women, aged 5–91 years, mean 57.6.

Results and conclusions
In the study, all incidental findings (IFs) detected in 230 CT examinations were analysed, and their total number was 1816 (7.9 /examination). IFs were found in 227 (98.7%) results. At least one IF was described for all women and for 119 of 122 men. The detected IFs were divided according to their significance into changes that were clinically significant for the patient’s health or life (category 1) and not significant (category 2). Category 1 consisted of 1459 abnormalities (80.3%), and category 2 consisted of 357 (19.7%) IFs. In the study group, at least one clinically significant IF was reported in 105/108 women (97.2%) and in 113/122 men (92.6%). Moreover, 3 subcategories were distinguished in the group of I: category 1a – changes significant without the need for further diagnostic procedures (613 abnormalities – 33.8%); category 1b – significant changes in which further planned diagnostic or therapeutic procedures are indicated – 815 (44.9%); and category 1c – significant changes requiring urgent procedures – 31 (1.7%).