Broad view of heart shows otherwise missed diagnoses

Almost a quarter of all patients in a recent U.S. study who underwent CT angiography had findings outside the heart and great vessels. Several serious diagnoses were missed with a limited viewing approach (looking at just the heart and great vessels). Use of the broad viewing approach led to more workup and follow-up imaging.

Sixteen hundred and forty-two of 6920 patients had one or more extracardiac findings for a total of 1901 findings in the broad viewing scheme. Of all the patients, 16.2% had a finding necessitating therapy, workup, or follow-up. By engaging in just the focused viewing scheme, most therapy (90.9%), workup (64.1%), and followup (51.2%) needs were missed (AJR 2010;195[1]:143-148).

Use of the focused approach resulted in fewer false-positive diagnoses, but five malignant tumors of the breast, 88 lung infiltrates, 43 cases of adenopathy, two cases of polycystic kidney disease, one breast abscess, and one case of splenic flexure diverticulitis were missed.