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01.03.2016 | CHEST RADIOLOGY

Under-reporting of cardiovascular findings on chest CT

verfasst von: Nicola Sverzellati, Teresa Arcadi, Luca Salvolini, Roberto Dore, Maurizio Zompatori, Manuela Mereu, Giuseppe Battista, Ilenia Martella, Francesco Toni, Luciano Cardinale, Erica Maffei, Fabio Maggi, Filippo Cademartiri, Tommaso Pirronti

Erschienen in: La radiologia medica | Ausgabe 3/2016

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Abstract

Purpose

It is unclear whether (and, to what extent) radiologists look at and report cardiovascular abnormalities on non-cardio-synchronized standard chest computed tomography (CT). In this study, the frequency and the reporting rate of cardiovascular findings in chest CT examinations were retrospectively assessed.

Materials and methods

This study was approved by the institutional review board of each participating center. Four academic centers provided data on 447 subjects who underwent non-ECG-synchronized chest CT examinations for evaluating pulmonary fibrosis (161/447, 36 %), suspected pulmonary embolism (140/447, 31.3 %), or lung cancer staging (146/447, 32.7 %). A total of 220/447 (53.7 %) and 227/447 CT (46.3 %) examinations were evaluated and reported by junior and senior chest radiologists, respectively. Two radiologists with training in cardiac imaging reviewed the same chest CT images looking for the presence of incidental cardiovascular abnormalities using a preformatted score sheet. Inter-observer agreement was assessed using the kappa coefficient of agreement (k).

Results

Inter-observer agreement between the study reviewers was moderate to good (0.4–0.73) for most of the incidental cardiovascular findings. At least one incidental cardiovascular finding not documented in the original report was identified by the study reviewers in 225/409 (55 %) of chest CT examinations. A total of 168/266 (63.2 %) potentially clinically significant cardiovascular findings were unreported in the original reports of 177/447 (39.6 %) subjects (p < 0.0001). Senior radiologists tended to more frequently report coronary artery calcification (p = 0.0006), cardiac valves calcification (p = 0.0003), and ascending aorta enlargement (p = 0.01) compared to junior radiologists.

Conclusions

Several cardiovascular abnormalities can be reliably identified on standard chest CT. Yet, they are often under-reported, even when they might be relevant to the patient’s work-up.

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Titel: Under-reporting of cardiovascular findings on chest CT
verfasst von: Nicola Sverzellati
Teresa Arcadi
Luca Salvolini
Roberto Dore
Maurizio Zompatori
Manuela Mereu
Giuseppe Battista
Ilenia Martella
Francesco Toni
Luciano Cardinale
Erica Maffei
Fabio Maggi
Filippo Cademartiri
Tommaso Pirronti
Publikationsdatum: 01.03.2016
Verlag: Springer Milan
Erschienen in: La radiologia medica / Ausgabe 3/2016
Print ISSN: 0033-8362
Elektronische ISSN: 1826-6983
DOI: https://doi.org/10.1007/s11547-015-0595-0

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Under-reporting of cardiovascular findings on chest CT