FEASIBILITY OF LIMITED ECHO IMAGING - CHARACTERIZATION OF INCIDENTAL FINDINGS

To evaluate the feasibility of limiting the extent of the echocardiogr aphic examination without omitting significant incidental findings, we reviewed consecutive reports from full echo studies performed in a te rtiary medical center with the following referral questions: ''rule-ou t pericardial effusion'' (n = 40) and ''rule-out source of embolus'' ( n = 132), Specific limited echo imaging protocols were formulated with out unnecessary imaging (that is, unrelated to the diagnostic question ) or use of Doppler. The percentage of full echo studies with, signifi cant incidental findings was determined, categorized by patient age, a nd then recalculated by whether the specific limited imaging protocol could potentially detect any or all of the incidental findings. The pe rcentage of cases with significant incidental findings was 45% and 36% in the ''rule-out'' pericardial effusion and source of embolus groups , respectively. This percentage was dependent on age <65 years versus greater than or equal to 65 years (22% vs 42%, p < 0.005). Limited ima ging protocols could identify greater than or equal to 85% of cases wi th significant incidental findings. These data suggest that limited ec ho imaging may be feasible in certain patient groups and referral diag noses.