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Coronary Artery Imaging with Contrast-Enhanced MDCT: Extracardiac Findings

Sabine Haller1, Christoph Kaiser2, Peter Buser2, Georg Bongartz1 and Jens Bremerich1

1 Department of Radiology, University Hospital Basel, Petersgraben 4, Basel CH-4054, Switzerland.
2 Department of Cardiology, University Hospital Basel, Basel, Switzerland.


Figure 1
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  		Fig. 1 —Graphic shows incidence of extracardiac findings on coronary artery MDCT. No findings were detected in 125 patients (75.3%); minor, in 33 (19.9%); and major extracardiac findings that required immediate workup, treatment, or both in eight (4.8%).

 

Figure 2
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  		Fig. 2A —Selected coronary artery MDCT images from patients with extracardiac findings not requiring immediate workup or treatment and thus classified as minor. 55-year-old woman with anatomic variation of right subclavian artery (arteria lusoria, arrow), which courses behind esophagus.

 

Figure 3
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  		Fig. 2B —Selected coronary artery MDCT images from patients with extracardiac findings not requiring immediate workup or treatment and thus classified as minor. 67-year-old woman with aneurysm of ascending aorta (asterisk); maximum diameter is 4.6 cm.

 

Figure 4
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  		Fig. 2C —Selected coronary artery MDCT images from patients with extracardiac findings not requiring immediate workup or treatment and thus classified as minor. 64-year-old man with pulmonary fibrosis (arrows) and emphysema (arrowhead).

 

Figure 5
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  		Fig. 3A —43-year-old man with recurrent dyspnea and chest pain referred for evaluation of coronary arteries on coronary artery MDCT. Image shows no relevant coronary artery disease in right coronary artery (open arrow), but filling defects (solid arrow) are seen in left lower lobe pulmonary artery.

 

Figure 6
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  		Fig. 3B —43-year-old man with recurrent dyspnea and chest pain referred for evaluation of coronary arteries on coronary artery MDCT. Image shows normal left anterior descending artery (double arrows) and pulmonary emboli (single arrow).

 

Figure 7
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  		Fig. 3C —43-year-old man with recurrent dyspnea and chest pain referred for evaluation of coronary arteries on coronary artery MDCT. Image shows triangular-shaped peripheral consolidation in left lower lobe (arrowhead), which indicated pulmonary infarction. Pulmonary emboli were classified as major extracardiac findings.

 

Figure 8
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  		Fig. 4A —Coronary artery MDCT revealed bronchial carcinoma in two patients. Image of 61-year-old man shows spiculated mass in anterior upper lobe segment (arrows).

 

Figure 9
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  		Fig. 4B —Coronary artery MDCT revealed bronchial carcinoma in two patients. Image of same patient as in A also shows mass (arrow). Transbronchial biopsy of hilar lymph node metastasis revealed adenocarcinoma.

 

Figure 10
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  		Fig. 4C —Coronary artery MDCT revealed bronchial carcinoma in two patients. 77-year-old man with spiculated mass in left anterior upper lobe segment (arrowhead) with diameter of 2.7 cm. Histology confirmed diagnosis of adenocarcinoma.

 

Figure 11
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  		Fig. 5 —Bar graph shows volumes of entire chest from apex to base of lungs (chest MDCT) compared with volumes displayed on coronary artery MDCT reconstructed with maximum field of view (coronary artery MDCTFOVmax) and typical coronary artery MDCT with field-of-view setting focused on heart (coronary artery MDCT). Volume displayed on coronary artery MDCTFOVmax is significantly larger than that on coronary artery MDCT (p < 0.001). Thus, analysis of extracardiac findings based on images reconstructed with maximum field of view is desirable.

 

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