Broad view of heart shows otherwise missed pathology

September 13, 2010

Almost a quarter of all patients in a recent study who underwent CT angiography had findings outside the heart and great vessels, leading to several serious diagnoses being missed.

Almost a quarter of all patients in a recent study who underwent CT angiography had findings outside the heart and great vessels, leading to several serious diagnoses being missed. A broad viewing approach led to more workup and follow-up imaging.

Out of 6920 patients, 1642 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 follow-up (51.2%) needs were missed (AJR 2010;195:143-148).

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.