In 16 patients, lung nodules larger than 4 millimeters in diameter showed up -- two of which were later found to be stage 1 lung cancer. Eleven patients were shown to have a potentially serious lung disease, either emphysema or another condition. Four had fluid buildup in the lungs. Twelve patients had enlarged lymph nodes in the chest and three had masses in the upper anterior chest.
Twenty patients had fluid in the sac that surrounds the heart; most of them were minor but one was major. Eight patients had an aneurysm or dissection in the upper part of their aorta, and one patient had blood clots threatening to block arteries in his lungs.
Since the upper part of the abdomen is visible when imaging the lower part of the heart during CT scanning, the researchers were also able to see potential problems there. Seven patients had lesions on their livers, one had a mass in his or her pancreas, and other patients had other findings.
In all, Patel says, the high rate of non-heart findings drives home the importance of having a team-based approach to reading CTCA scans. At U-M, cardiologists and thoracic radiologists routinely take this cooperative approach.
The American College of Radiology has just issued a Clinical Statement on Noninvasive Cardiac Imaging online that will be published in the June issue of the journal Radiology. It calls for specialized training, education and levels of experience for both radiologists who read CTCA images and the technologists who conduct the scans. Performing diagnostic-quality scans requires fine-tuning of the scanning parameters that relies on the combined expertise of the radiologist and technologist.
Meanwhile, Patel and her U-M colleagues are currently performing research that directly compares CTCA and coronary angiograms performed in the traditional way, using a catheter that is threaded into the coronary arteries to inje
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
16-May-2005