Purpose or Case Report: The advent of fast CT scanners with lower radiation doses has resulted in rapid growth in the numbers of cardiac CTs being performed in children. This has also increased the number of CTs interpreted by cardiologists, similar to adult cardiac CT. Pediatric cardiac CT demonstrates multiple potential extracardiac variants and pathology that may occur in conjunction with congenital heart disease (CHD). Prior publications in adult cohorts demonstrate a wide-range and incidence of extracardiac findings (6-39%) but the prevalence in children is unknown. Therefore, the purpose of this abstract is to describe incidence, distribution and significance of the extracardiac findings found in pediatric cardiac CT at a tertiary referral center.
Methods & Materials: Our institutional review board approved this HIPAA-compliant retrospective study; informed consent was waived. We identified all (n=262) records for patients who received a Cardiac CT study between January 1 and August 1, 2019 at our tertiary referral children’s hospital. All non-cardiac indicated CT angiograms (including airway and vascular ring studies) were excluded.
CT reports were interrogated for extracardiac findings categorized by system (airway, lung, vascular, abdomen, malpositioned lines and miscellaneous). Each of these findings was subclassified by level of clinical importance based upon the need for urgent intervention or treatment.
Results: 262 dedicated cardiac CT exams were performed in the 8 month time period. Patient age: median 3 years, range 3.6 days-56 years. Of the 262 exams, 56 (21%) demonstrated clinically important findings (airway n=10, pulmonary n=27, vascular n=13, abdomen n=2, malpositioned lines n=4, new neuroblastoma n=1), of which 19 (7%) were deemed to be of critical importance including pneumothorax, lung collapse, dissection, venous obstruction, necrotizing enterocolitis and endobronchial intubation.
Conclusions: Extracardiac findings are relatively common in pediatric cardiac CT, highlighting the importance of interpretation by experienced pediatric radiologists.