scholarly journals 117 Incidental finding of coronary artery calcification in non-triggered high-resolution thoracic computed tomography: a retrospective study of reporting standards in a single trust

Heart ◽  
2017 ◽  
Vol 103 (Suppl 5) ◽  
pp. A88.2-A89
Author(s):  
Sushant Saluja ◽  
Janousek Pavel ◽  
Divya Raj ◽  
Bruce Irwin ◽  
David Zhu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Coronary Artery ◽  
High Resolution ◽  
Coronary Artery Calcification ◽  
Incidental Finding ◽  
Reporting Standards ◽  
Thoracic Computed Tomography

scholarly journals Reporting incidental coronary, aortic valve and cardiac calcification on non-gated thoracic computed tomography, a consensus statement from the BSCI/BSCCT and BSTI

2021 ◽  
Vol 94 (1117) ◽  
pp. 20200894
Author(s):  
Michelle Claire Williams ◽  
Ausami Abbas ◽  
Erica Tirr ◽  
Shirjel Alam ◽  
Edward Nicol ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Coronary Artery Calcification ◽  
Consensus Statement ◽  
Incidental Finding ◽  
Aortic Valve Calcification ◽  
Thoracic Ct ◽  
Thoracic Computed Tomography ◽  
Valve Annulus ◽  
Artery Disease

Incidental coronary and cardiac calcification are frequent findings on non-gated thoracic CT. We recommend that the heart is reviewed on all CT scans where it is visualised. Coronary artery calcification is a marker of coronary artery disease and it is associated with an adverse prognosis on dedicated cardiac imaging and on non-gated thoracic CT performed for non-cardiac indications, both with and without contrast. We recommend that coronary artery calcification is reported on all non-gated thoracic CT using a simple patient-based score (none, mild, moderate, severe). Furthermore, we recommend that reports include recommendations for subsequent management, namely the assessment of modifiable cardiovascular risk factors and, if the patient has chest pain, assessment as per standard guidelines. In most cases, this will not necessitate additional investigations. Incidental aortic valve calcification may also be identified on non-gated thoracic CT and should be reported, along with ancillary findings such as aortic root dilation. Calcification may occur in other parts of the heart including mitral valve/annulus, pericardium and myocardium, but in many cases these are an incidental finding without clinical significance.

scholarly journals The clinical implications of incidental coronary artery calcification in routine, non-triggered high-resolution thoracic computed tomography: a retrospective study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Saluja ◽  
J Sobolewska ◽  
K Khan ◽  
H Contractor ◽  
L.J Mitchell ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Risk Factor ◽  
Coronary Artery ◽  
High Resolution ◽  
Independent Risk Factor ◽  
Incidental Finding ◽  
Agatston Score ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Coronary artery calcium (CAC) is a marker of atherosclerosis and an independent risk factor for cardiac-related mortality. The measurement of this score has traditionally been based on using ECG triggered computed tomography (CT). However, CAC, identified on non-contrast high resolution chest computed tomography (HRCT), should be considered diagnostic for coronary artery disease (CAD). We aimed to evaluate the incidental prevalence and burden of CAC on non-gated HRCT thorax used for patients undergoing lung cancer screening or follow-up for interstitial lung disease. We also assessed how often Radiologists reported CAC as an incidental finding on these scans. Methods Computerised Radiology Information Service (CRIS) was manually searched to determine all HRCT scans performed in our Trust from 01/05/2018 to 01/05/2019. The reports issued by Radiologists and images of selected studies were reviewed. Results 2185 HRCT scans were performed over this period. Patients were divided into three groups of age <50 (Group 1); 50-<60 (Group 2) and 60 (Group 3). 100 scans were randomly selected from each group using a random number generator to give a total of 300 patients. The mean ages of patients in Group 1, 2 and 3 were 48.3±2.3, 54.8±2.4 and 65±3.2 respectively. There was, approximately, the same number of males as females in each group. CAC was noted in 15% of scans in Group 1, 82% of scans in Group 2 and 94% scans in Group 3. CAC was only noted in 1/15 (6.7%) of scan reports in Group 1, 41/82 (50%) in Group 2 and 37/94 (39.4%) in Group 3. Among the 79 patients with radiologist-reported incidental CAC, statin and aspirin prescriptions increased by approximately 7 percentage points each. A diagnosis of CAD was eventually made in 9 (11.4%) patients through functional imaging or coronary angiogram. Two authors independently calculated the Agatston scores of HRCT scans whose reports did not comment on the degree of calcification. We excluded 15/112 (13.4%) scans as they were uninterpretable due to motion artefacts. Of the remaining 97 scans analysed 58/97 (59.8%) had severe CAC with an Agatston score of >400 with the remaining showing moderate calcification (101–400). Cohen κ agreement between the two authors rating was 0.90 (95% confidence interval [CI] 0.87–0.96). Group 2 and 3 had significantly more patients with severe CAC then group 1 (p<0.001). Left anterior descending artery was most commonly affected. Conclusion This study shows that CAC is under reported on non-gated HRCT scans which represents a missed opportunity to implement strategies for primary and secondary prevention. Given that respiratory disease is an independent risk factor for developing cardiac disease, it is incumbent upon the interpreting clinician to report all findings and ensure that critical findings are highlighted. The images of calcified coronary arteries may also potentially have a role in convincing people to make correct lifestyle choices. Funding Acknowledgement Type of funding source: None

scholarly journals Association between the Severity of Nonalcoholic Fatty Liver Disease and the Risk of Coronary Artery Calcification

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 807
Author(s):  
Chien-Chih Chen ◽  
Wei-Chien Hsu ◽  
Han-Ming Wu ◽  
Jiun-Yi Wang ◽  
Pei-Yu Yang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiovascular Risk ◽  
Liver Disease ◽  
Coronary Artery ◽  
Fatty Liver ◽  
Multidetector Computed Tomography ◽  
Coronary Artery Calcification ◽  
Fatty Liver Disease ◽  
Calcium Score ◽  
Left Main

Background and Objectives: There are limited data on the association between severity of non-alcoholic fatty liver disease (NAFLD) and coronary artery calcification. This study investigated sonographic diagnosed NAFLD and coronary artery calcium score (CAC) as detected by cardiac multidetector computed tomography in general populations. Materials and Methods: A total of 545 patients were enrolled in this study. NAFLD was diagnosed by ultrasonography examination and CAC score were evaluated by cardiac multidetector computed tomography. The association between NAFLD and artery calcium score stage was determined by logistic regression analysis and Spearman correlation coefficient analysis. Results: Of all the participants, 437 (80.2%) had ultrasonography-diagnosed NAFLD and 242 (44%) had coronary artery calcification (CAC > 0). After adjustment for cardiovascular risk factors, the risk of developing coronary artery calcification was 1.36-fold greater in the patients with different severity of NAFLD compared to those without NAFLD (OR = 1.36, 95% CI = 1.07–1.77, p = 0.016). The highest OR for separate coronary artery calcification was 1.98 (OR = 1.98, 95% CI = 1.37–2.87, p < 0.001) in the left main artery, and the risk was still 1.71-fold greater after adjustments (OR = 1.71, 95% CI = 1.16–2.54, p = 0.007). Conclusions: This cross-sectional study demonstrated that the severity of NAFLD was associated with the presence of significant coronary artery calcification, especially in the left main coronary artery, suggesting increasing the cardiovascular risk.

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