Extravascular findings during upper limb computed tomographic angiography focusing on undiagnosed malignancy

• 作者: Athanasios Diamantopoulos Hiba Abbas Jeeban Das Leo Monzon Narayanan Thulasidasan Panos Gkoutzios Romman Nourzaie Shahzad Ilyas Steven Moser Tarun Sabharwal
• 来源期刊: 世界放射学杂志:英文版(电子版)
• 学科: 医学
• 关键词: Extravascular INCIDENTAL FINDINGS Computed ANGIOGRAPHY Upper LIMBS Arterial Extravascular FINDINGS
• 年，卷（期）: 2019,（1）
• 页码范围: 10-18
• 页数: 9页
• 分类号: R

摘要

BACKGROUND Computer tomography angiography(CTA)has been an established method for diagnostic vascular disease of lower limbs.Recently,the method is widely used for diagnosis of vascular pathologies in the upper limbs too.It also has increased the possibilities of this scans being reviewed by no specially trained radiologists.This increases the risk of incidental non vascular findings to be missed or misinterpreted.The study is focusing in the frequency of extravascular incidental finding(EVIF)and highlights the importance for both the reporting radiologist and the referring physician recognizing the frequency of EVIFs.AIM To analyse the frequency of EVIF identified on computed angiography(CT)of the upper limb.METHODS A total of 1383 CT angiographic studies of the peripheral arterial system were performed between August 2015 and August 2017.All upper limb CTAs(n=79)were retrospectively reviewed for the presence of non-vascular incidental findings within the chest,abdomen/pelvis,musculoskeletal system or head and neck.These EVIFs were subsequently grouped into 3 categories based on clinical significance.EVIFs of immediate clinical relevance were included in category A,findings considered indeterminate but most likely benign were placed in category B,while incidental findings of no clinical significance were included in category C.RESULTS Complete imaging datasets were available in 74/79(93.7%).Patient demographics included 39(52.7%)females and 35(47.2%)males with a mean age of 59±19.5 years(range 19-93 years).A total of 153 EVIFs were reported in 52 patients(70.3%).Of these,44 EVIFs(28.7%)were found in the chest,83(54.2%)in the abdomen,14(9.2%)in the musculoskeletal system and 9(5.8%)in the head and neck.Thirteen EVIFs(8.4%)identified in 11 patients were noted to be of immediate clinical significance(Category A),50 EVIFs(32.3%)were identified in 20 patients and were considered indeterminate but most likely benign,while the remaining 91 EVIFs(59.5%)identified in 21 patients were determined to be of no clinical sign