Cardiac and non cardiac collateral findings assessment in multislice CT coronary angiography

Purpose: While scanning the heart and the coronary arteries, non-cardiac collateral findings may be revealed but are usually not assessed. The aim of the study is to describe the prevalence of non-cardiac collateral findings during MSCT-CA in a multicenter study. Methods and Materials: 540 patients undergoing MSCT-CA with 64-slice MDCT-CA acquired between 05/2008 and 09/2010 due to suspected coronary artery disease were retrospectively reviewed. All datasets obtained with a large Field of view (FOV) were in blind analysed by 2 radiologists, using standard mediastinal and lung window settings. Collateral findings were divided according to clinical importance into: non significant, remarkable and compulsory to be investigated. Among significant diseased patients, medical records were reviewed to check the clinical follow-up, subsequent examinations, or surgical procedures of non-cardiac abnormalities in the 6 months after MSCT-CA. Results: 72 % of the patients revealed coronary artery disease. Only 106/540 (19.6%) patients were without any additional finding. 637 additional findings were recorded, divided into non significant findings: 266 (41.75%), mild: 339 (53.21%), 32 (5.02%) compulsory to be studied. 63 (9.89) of these were recorded as cardiac collateral finding. A total of 27 patients (5.30%) had significant non-cardiac pathology requiring clinical or radiological follow-up. Among these new discovered pathologies were revealed in 3/540 patients (0.55%). Conclusion: A significant number of non-cardiac findings might have been missed in MSCT-CA scans if the evaluation is limited to the heart