The “cardiac neglect”: a gentle reminder to radiologists interpreting contrast-enhanced abdominal MDCT

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Ann-Katrin Kaufmann-Bühler¹  Emina Talakić²  Florian Hohenberg²  Ksenija Mijović³  Helmut Schöllnast⁴  Michael Fuchsjäger⁵  Sebastian Tschauner⁵  Eszter Nagy⁵ 

[1] Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany;Division of General Radiology, Department of Radiology, Medical University of Graz, Austria;Division of General Radiology, Department of Radiology, Medical University of Graz, Austria;Emergency Radiology Department, Center for Radiology and MRI, University Clinical Center of Serbia, Belgrade, Serbia;Division of General Radiology, Department of Radiology, Medical University of Graz, Austria;Institute of Radiology, Graz, Austria;Division of Paediatric Radiology, Department of Radiology, Medical University of Graz, Austria;

关键词: diagnostic imaging;    multidetector computed tomography;    contrast media;    abdomen;    abdominal pain;    myocardial infarction;    missed diagnosis;   

DOI  :  10.3389/fcvm.2023.1147166

 received in 2023-01-18, accepted in 2023-03-24,  发布年份 2023

来源: Frontiers

【 摘 要 】

Myocardial infarction (MI) may be visible on contrast-enhanced multidetector computed tomography (MDCT) scans of the abdomen. In the previous literature, potentially missed MI in abdominal MDCTs was not perceived as an issue in radiology. This retrospective single-center study assessed the frequency of detectable myocardial hypoperfusion in contrast-enhanced abdominal MDCTs. We identified 107 patients between 2006 and 2022 who had abdominal MDCTs on the same day or the day before a catheter-proven or clinically evident diagnosis of MI. After reviewing the digital patient records and applying the exclusion criteria, we included 38 patients, with 19 showing areas of myocardial hypoperfusion. All MDCT studies were non ECG-gated. The delay between the MDCT examination and MI diagnosis was shorter in studies with myocardial hypoperfusion (7.4±6.5 hours and 13.8±12.5 hours) but not statistically significant p=0.054. Only 2 of 19 (11%) of these pathologies had been noted in the written radiology reports. The most common cardinal symptom was epigastric pain (50%), followed by polytrauma (21%). STEMI was significantly more common in cases of myocardial hypoperfusion p=0.009. Overall, 16 of 38 (42%) patients died because of acute MI. Based on extrapolations using local MDCT rates, we estimate several thousand radiologically missed MI cases worldwide per year.

【 授权许可】

Unknown   
© 2023 Talakić, Schöllnast, Kaufmann-Bühler, Hohenberg, Mijovic, Nagy, Fuchsjaeger and Tschauner.