Prevalence of cardiac and extracardiac incidental findings in the evaluation of coronary artery disease by multidetector computed tomography

Background. With the widespread use of multidetector computed tomography (MDCT) coronary angiography, cardiac and extracardiac incidental findings in cardiac imaging might be detected. The aim of this study was to determine the prevalence of cardiac and extracardiac incidental findings in a population of consecutive patients undergoing coronary MDCT. Methods. A total of 840 consecutive patients with known or suspected heart disease underwent cardiac MDCT. All patients were assessed with 64-slice MDCT; the examination was performed by limiting the anatomical region examined between the bifurcation of the trachea and the cardiac apex with the aim of obtaining excellent image quality and low cardiac radiological exposure. Results. Overall, 81 incidental findings in 72 patients (9%) were identified, of which 18 were cardiac (2%) and 63 extracardiac (7%). Extracardiac incidental findings were mainly represented by pulmonary nodules (19%). Conclusions. A significant number of cardiac and extracardiac incidental findings were observed at cardiac MDCT, with the prevalence depending on technical aspects of image acquisition and patient characteristics. Incidental findings should be carefully searched for and reported because they may have an impact on clinical follow-up indications that is not without cost and risk.