Prevalence and clinical significance of accidental findings in electron-beam tomographic scans for coronary artery calcification.


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.

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@article{Hunold2001PrevalenceAC, title={Prevalence and clinical significance of accidental findings in electron-beam tomographic scans for coronary artery calcification.}, author={Peter Hunold and Axel Schmermund and R. M. M. Seibel and Dietrich H. W. Gr{\"{o}nemeyer and Raimund Erbel}, journal={European heart journal}, year={2001}, volume={22 18}, pages={1748-58} }