E1179. Essential, Not Incidental: Clinically Significant Findings on CT Angiography of the Head and Neck
  1. Clara Koo; Icahn School of Medicine at Mount Sinai
  2. Colton Welch; Icahn School of Medicine at Mount Sinai
  3. Anthony Yang; Icahn School of Medicine at Mount Sinai
  4. Puneet Belani; Icahn School of Medicine at Mount Sinai
  5. Michael Schecht; Icahn School of Medicine at Mount Sinai
  6. Jacqueline Junn; Icahn School of Medicine at Mount Sinai
Non-contrast computed tomography (CT) of the head and CT Angiography (CTA) of the head and neck (aortic arch to vertex) are part of the comprehensive CT algorithm for patients with suspected ischemic stroke. CTA of the head and neck aims to enhance the carotid and vertebral arteries with minimal venous contamination. Various incidental findings in the upper chest, lower head, and neck may be identified on these scans that differ in clinical significance and impact clinical care. Approximately 40% of incidental findings of major clinical relevance in patients undergoing ischemic workup were not mentioned in the primary radiology report. Some of the most frequently missed clinical findings were pulmonary embolism, pathologic fractures, and erosions. Our goal is to educate radiologists on both common and uncommon incidental findings, many of which can have major clinical relevance.

Educational Goals / Teaching Points
Review spectrum of important incidental findings on CT angiography (CTA) of the head and neck obtained primarily for ischemic work up. Expand understanding and recognition of potentially significant clinical findings outside of the targeted findings of the brain and neck arterial vasculature.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
In this exhibit, we want to demonstrate a wide range of potentially significant incidental findings found on patients undergoing CTA of the head and neck and emphasize their importance. We will demonstrate vascular, malignant, cardiac, pulmonary, and other incidental findings found on CTA head and neck done primarily for ischemic workups.

Through this educational exhibit, radiologists will gain a better understanding and reinforcement of various clinically significant findings outside the primary findings expected within the brain and targeted vessels. They will better understand the clinical importance of incidental findings and how they may directly impact patient care.