Prevalence and clinical significance of accidental findings in electron-beam tomographic scans for coronary artery calcification

Alms To analyse the prevalence, and diagnostic and therapeutic consequences , of accidental findings in electron-beam tomographic scans performed for e valuation of coronary artery calcification. Methods and Results A total of 1812 consecutive patients with known or susp ected coronary artery disease underwent electron-beam tomography. In 583 (3 2%) of the patients, i.v. contrast was also administered for non-invasive c oronary angiography. A total of 2055 non-coronary pathological findings wer e observed in 953 (53%) of the patients. The prevalence of extra-cardiac di sease, as shown in native scans and contrast studies, was assessed separate ly. In 583 (32%) patients, cardiac structures or the pericardium were affec ted, in 423 (23%) aortic disease was found. Lung disease was found in 357 ( 20%), and pathology of other organs in 273 patients (15%). The most frequen t findings were aortic calcium in 423 (23%) patients and heart valve calcif ication in 317 patients (17%). Malignant disease could be detected in three patients. Further diagnostic investigations were done in 191 (11%) patient s, 141 (74%) of which concerned the heart. In 22 (1.2%) patients, specific therapy was initiated following electron-beam tomographic findings. Conclusion Accidental non-coronary pathology is a frequent finding in elect ron-beam tomographic calcium scanning, and often requires diagnostic or the rapeutic action. Profound knowledge of the radiological differential diagno sis of the thoracic organs is necessary for reporting electron-beam tomogra phic scans, in order to avoid misdiagnosis and to receive a high quality in terpretation.