Copyright © 2001 by the European Society of Cardiology.
Prevalence and clinical significance of accidental findings in electron-beam tomographic scans for coronary artery calcification
a Department of Cardiology, University of Essen, Germany
b Institute of Diagnostic and Interventional Radiology, University of Witten/Herdecke, Mülheim, Germany
c Institute for Microtherapy, University of Witten/Herdecke, Bochum, Germany
revised December 19, 2000; accepted December 20, 2000
Abstract
Aims To analyse the prevalence, and diagnostic and therapeutic consequences, of accidental findings in electron-beam tomographic scans performed for evaluation of coronary artery calcification.
Methods and Results A total of 1812 consecutive patients with known or suspected coronary artery disease underwent electron-beam tomography. In 583 (32%) of the patients, i.v. contrast was also administered for non-invasive coronary angiography. A total of 2055 non-coronary pathological findings were observed in 953 (53%) of the patients. The prevalence of extra-cardiac disease, as shown in native scans and contrast studies, was assessed separately. In 583 (32%) patients, cardiac structures or the pericardium were affected, in 423 (23%) aortic disease was found. Lung disease was found in 357 (20%), and pathology of other organs in 273 patients (15%). The most frequent findings were aortic calcium in 423 (23%) patients and heart valve calcification in 317 patients (17%). Malignant disease could be detected in three patients. Further diagnostic investigations were done in 191 (11%) patients, 141 (74%) of which concerned the heart. In 22 (1·2%) patients, specific therapy was initiated following electron-beam tomographic findings.
Conclusion Accidental non-coronary pathology is a frequent finding in electron-beam tomographic calcium scanning, and often requires diagnostic or therapeutic action. Profound knowledge of the radiological differential diagnosis of the thoracic organs is necessary for reporting electron-beam tomographic scans, in order to avoid misdiagnosis and to receive a high quality interpretation.
Key Words: Electron beam tomography, thoracic organs, coronary artery, coronary artery calcium, cardiovascular disease, non-invasive imaging
f1 Correspondence: Prof. Dr Raimund Erbel, Department of Cardiology, Division of Internal Medicine, University of Essen, Hufelandstrasse 55, 45122 Essen/Germany.
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