Clinical value of multi-detector computed tomography source image on detecting extracoronary abnormalities
10.3760/cma.j.issn.0253-3758.2013.08.013
- VernacularTitle:多层螺旋CT冠状动脉成像中源图像对冠状动脉以外病变的诊断价值
- Author:
Li LU
1
;
Long-Jiang ZHANG
;
Fei-Peng ZHU
;
Li-Xiang XIE
;
Hong MA
;
Jia-Li WANG
;
Kai XU
Author Information
1. 221000,徐州医学院附属医院影像科
- Keywords:
Tomography,spiral computed;
Coronary disease;
Lung diseases;
Mediastinal diseases
- From:
Chinese Journal of Cardiology
2013;41(8):687-692
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the clinical value of multi-detector computed tomography (MDCT)source image on detecting extracoronary abnormalities in a large cohort of patients with suspected coronary artery disease (CAD).Method MDCT source images from 3240 consecutive patients (mean 64.5 years)with suspected CAD were reviewed retrospectively by 2 readers.Extra-coronary findings were classified according to involved organ and level of clinical significance.Following organs were examined:lungs,upper abdomen,spine,chest wall,mediastinum and vascularatures.Clinical relevance of extracoronary findings was considered as either "significant" or "non-significant"."Significant" findings were subclassified as score 1:findings necessitating immediate therapeutic actions,or score 2:findings with uncertain clinical or prognostic relevance,requiring clinical awareness,follow-up or further investigations (non-urgent)."Nonsignificant" findings were assigned to score 3:findings without clinical implication.The irrelevant incidental findings (e.g.spinal degenerative changes,aortic calcification) were not analyzed.Results Extracoronary findings was evidenced in 330 patients with 424 abnormalities,20.3％ (67/330) patients had multiple lesions,16.5％ lesions were located in the lungs,13.2％ lesions found in the upper abdomen,56.8％ (241/424)lesions evidenced in the mediastinum,0.9％ (4/424)lesions seen in the spine and chest wall,13.9％ (53/424) lesions were related to other vascular disease.Pleural effusion accounts for 5.5％ of the mediastinum lesions.Incidence of heart cavity enlargement,heart valve disease,pericardial effusion/ calcification,atrial/ventricular perfusion defects,myocardial disease,congenital heart disease,ventricular aneurysmwas 14.7％ (56/380),15.5％ (59/380),10.8％ (41/380),3.9％ (15/380),0.8％ (3/380),1.6％ (6/380),and 1.8％ (7/380) respectively.The clinical significance score 1-3 was 8.5％ (36/424),81.1％ (344/424),and 10.4％ (44/424) respectively.Incidence of detected extracoronary findings was the highest by bone window and the lowest by lung window.Incidence of extarcoronary findings was not related to CAD (x2 =81.76,C =0.155,P ＞ 0.05).Inter-reader agreement on extracoronary findings was excellent (Kappa =0.934,P ＞ 0.05).Conclusion Our data show that it is of clinical value to observe and report extracoronary findings with source image of cardiac MDCT.
