Dana Galvan;
Department of Radiology, University of New Mexico
Emily Funsten;
Department of Radiology, University of New Mexico
Hannah Hodges;
Department of Radiology, University of New Mexico
Sherry Wang;
Mayo Clinic Radiology
Douglas Katz;
NYU Langone Health
Jonathan Revels;
NYU Langone Health
Background
In recent years, nongated CT has undergone major advancements that have improved scanning times, temporal, and spatial resolution. The revolution in nongated CT has opened a window of opportunity for radiologists to accurately diagnose multiple cardiac pathologies without the need for a gated study. Familiarity with detectable findings is of utmost importance, especially because up to 66% of nongated CT scans have clinically incidental findings, such as coronary artery disease. Although one may believe that without gating the diagnosis of certain conditions may be challenging, we have compiled an easy-to-follow review of a wide range of cardiac conditions. The systematic approach will be guided by acuity level and anatomic location.
Educational Goals / Teaching Points
The goal of this educational exhibit is to enhance understanding of cardiac findings in nongated examinations. This objective will be accomplished by highlighting crucial cardiac anatomical landmarks, which encompass the pericardium, myocardium, cardiac chambers, appendages, and coronary arteries. Emphasis will particularly be placed on pathologies that are critical and life-threatening. Furthermore, the exhibit will delve into recognizing common pitfalls, such as anatomic variants and device complications, ultimately empowering learners to confidently identify frequently disregarded postprocedural and postsurgical cardiac problems.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit uses a pathologic review to guide learners through identification of essential cardiac anatomic landmarks on nongated chest CT examinations, utilizing an outside-inside approach to the heart. The exhibit will illuminate the normal, anticipated cardiac structures and measurements. The identification of cardiac pathologies will initiate with instances of pericardial abnormalities, followed by myocardial, cardiac chamber, and coronary artery cases. Each pathology will encompass a comprehensive examination of differential diagnoses, clinical significance, and applicable follow-up recommendations. This methodical, case-based approach aims to enhance learners' retention of knowledge concerning specific conditions. This approach underscores the significance of incorporating the heart into their search pattern when it is within the FOV.
Conclusion
Even without ECG-gating, an array of cardiac pathologies can be visualized on nongated chest CT examinations. The prompt identification of some of these conditions will allow prompt patient treatment and management, thereby improving patient care.
