Analysis of non-coronary findings in coronary CT angiography: differences in gender, age, location, and clinical significance in the Turkish population Analyse nicht-koronarer Befunde in der CT-Koronarangiografie: Unterschiede hinsichtlich Geschlecht, Alter, Lokalisation und klinischer Relevanz in der türkischen Bevölkerung

Isik M. İ., TAŞAR M.

RoFo Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren, 2026 (SCI-Expanded, Scopus)

Özet

Purpose The increasing use of coronary CT angiography (CCTA) in the diagnosis of coronary artery disease (CAD) necessitates the evaluation of non-coronary findings (NCFs) and the investigation of the origin of patients' symptoms. This study aims to analyze NCFs detected in patients undergoing CCTA for suspected CAD. Materials and Methods The study retrospectively evaluated a total of 1503 patients who underwent CCTA procedures at our clinic between January 2020 and January 2024. All images were evaluated visually by a single reader. No automated detection system was used. Benign conditions, anatomical variations, and all findings deemed to require follow-up or treatment within the imaging field were noted. NCFs identified in the CCTA examinations were analyzed based on patients' gender and age, NCF location, and clinical significance (no/mild, moderate, and severe). Results At least one NCF was identified in 1460 out of 1503 patients (97.2 %), with a total of 7822 NCFs detected. 45.4 % of the patients (n = 682) were male and 54.6 % (n = 821) were female. The median age was found to be 52 [19]–[87] years for males and 57 [22]–[84] years for females. The most common NCFs observed in all patients were, respectively, spinal degenerative changes (65.4 %, n = 983), parenchymal bands-subpleural lines (47.2 %, n = 709), increased CTR (41.4 %, n = 622), hiatal hernia (36.7 %, n = 552), and esophageal thickening (30.9 %, n = 464). Certain NCFs, including nodules > 8 mm (p = 0.007), hiatal hernia (p = 0.027), pulmonary artery dilatation (p = 0.048), breast lesions (p = 0.010), hyperdense liver lesions (p = 0.024), and adrenal gland thickening (p = 0.035), showed statistically significant differences between genders. Among NCFs, only scoliosis and age were found to have a significant but weak negative correlation (p < 0.048, r = –0.051). The most common findings of no/mild, moderate, and severe clinical significance were spinal degenerative changes (n = 983), thoracic aortic calcification (n = 622), and pulmonary parenchymal infiltration (n = 78), respectively. Conclusion Awareness of the variability in the distribution of NCFs based on age, gender, location, and clinical significance is crucial when evaluating CCTA scans performed for suspected CAD.