Reporting incidental coronary, aortic valve and cardiac calcification on non-gated thoracic computed tomography, a consensus statement from the BSCI/BSCCT and BSTI.
Michelle Claire WilliamsAusami AbbasErica TirrShirjel AlamEdward NicolJames ShambrookMatthias SchmittGareth Morgan HughesJames StirrupBen HollowayDeepa GopalanAparna DeshpandeJonathan Weir-McCallBobby AgrawalJonathan C L RodriguesAdrian J B BradyGiles RoditiGraham RobinsonRussell BullPublished in: The British journal of radiology (2020)
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.
Keyphrases
- aortic valve
- computed tomography
- coronary artery
- dual energy
- contrast enhanced
- image quality
- aortic stenosis
- coronary artery disease
- transcatheter aortic valve replacement
- transcatheter aortic valve implantation
- aortic valve replacement
- chronic kidney disease
- spinal cord
- left ventricular
- positron emission tomography
- pulmonary artery
- cardiovascular risk factors
- mitral valve
- magnetic resonance imaging
- magnetic resonance
- heart failure
- clinical practice
- mass spectrometry
- type diabetes
- case report
- early onset
- cardiovascular events
- high resolution
- cardiovascular disease
- atrial fibrillation
- percutaneous coronary intervention
- pulmonary arterial hypertension
- photodynamic therapy
- spinal cord injury
- adverse drug
- high intensity