Thoracic Pathologies on Scout Views and Bolus Tracking Slices for Computed Tomographic Cerebral Angiography

TY - JOUR

T1 - Thoracic Pathologies on Scout Views and Bolus Tracking Slices for Computed Tomographic Cerebral Angiography

AU - Groth, M

AU - Fiehler, J

AU - Henes, F O

AU - Buhk, J H

N1 - © Georg Thieme Verlag KG Stuttgart · New York.

PY - 2015/8

Y1 - 2015/8

N2 - PURPOSE: To evaluate the incidence of additional thoracic pathologic findings (TPF) detected on scout views and corresponding bolus tracking slices (SVBT) for computed tomographic cerebral angiography (CTCA) and to test the reliability and accuracy of these findings.MATERIALS AND METHODS: The study collective included 505 consecutive patients who underwent multidetector CTCA. Appendant SVBT of all patients were reviewed for any pathologic findings and patient medical reports were analyzed, if any medical treatment was initiated for the detected pathologic findings. In 18 patients thoracic CT scans were performed in the same session. These were additionally reviewed by two blinded observers to test for intra- and interobserver reliability as well as for accuracy of detecting thoracic pathologies on SVBT.RESULTS: TPF were detected in 165 (33%) SVBT. The five most common pathologic findings were: pleural effusion, 12%; pneumonia, 8%; atelectasis/dystelecatsis, 6%; pericardial effusion, 2% and elevated diaphragm, 1%. For 48 % of these findings medical treatment was initiated. SVBT showed a sensitivity of 53%, a specificity of 99%, a positive predictive value of 89%, a negative predictive value of 94% and accuracy of 94% for the detection of TPF. The intraobserver reliability was very good and the interobserver reliability showed moderate agreement.CONCLUSION: SVBT for CTCA should be reviewed with care by radiologists, since additional TPF can affect patient management. Nevertheless, despite a high specificity of SVBT for detecting TPF, an only moderate sensitivity has to be taken into account.KEY POINTS: Thoracic pathologies are frequently found on scout views for cerebral CTA. Reviewing additional bolus trigger slices will improve diagnostic sensitivity. Despite high specificity, scout views and trigger slices offer a moderate sensitivity. Evaluation of scout views and trigger slices can result in medical treatment.

AB - PURPOSE: To evaluate the incidence of additional thoracic pathologic findings (TPF) detected on scout views and corresponding bolus tracking slices (SVBT) for computed tomographic cerebral angiography (CTCA) and to test the reliability and accuracy of these findings.MATERIALS AND METHODS: The study collective included 505 consecutive patients who underwent multidetector CTCA. Appendant SVBT of all patients were reviewed for any pathologic findings and patient medical reports were analyzed, if any medical treatment was initiated for the detected pathologic findings. In 18 patients thoracic CT scans were performed in the same session. These were additionally reviewed by two blinded observers to test for intra- and interobserver reliability as well as for accuracy of detecting thoracic pathologies on SVBT.RESULTS: TPF were detected in 165 (33%) SVBT. The five most common pathologic findings were: pleural effusion, 12%; pneumonia, 8%; atelectasis/dystelecatsis, 6%; pericardial effusion, 2% and elevated diaphragm, 1%. For 48 % of these findings medical treatment was initiated. SVBT showed a sensitivity of 53%, a specificity of 99%, a positive predictive value of 89%, a negative predictive value of 94% and accuracy of 94% for the detection of TPF. The intraobserver reliability was very good and the interobserver reliability showed moderate agreement.CONCLUSION: SVBT for CTCA should be reviewed with care by radiologists, since additional TPF can affect patient management. Nevertheless, despite a high specificity of SVBT for detecting TPF, an only moderate sensitivity has to be taken into account.KEY POINTS: Thoracic pathologies are frequently found on scout views for cerebral CTA. Reviewing additional bolus trigger slices will improve diagnostic sensitivity. Despite high specificity, scout views and trigger slices offer a moderate sensitivity. Evaluation of scout views and trigger slices can result in medical treatment.

KW - Aged

KW - Aged, 80 and over

KW - Cerebral Angiography

KW - Female

KW - Humans

KW - Image Interpretation, Computer-Assisted

KW - Incidental Findings

KW - Male

KW - Middle Aged

KW - Multidetector Computed Tomography

KW - Observer Variation

KW - Retrospective Studies

KW - Sensitivity and Specificity

KW - Thoracic Diseases

U2 - 10.1055/s-0034-1399545

DO - 10.1055/s-0034-1399545

M3 - SCORING: Journal article

C2 - 26019049

VL - 187

SP - 691

EP - 696

JO - ROFO-FORTSCHR RONTG

JF - ROFO-FORTSCHR RONTG

SN - 1438-9029

IS - 8

ER -