Incidental thorax imaging findings in abdominal computed tomography: Results of a tertiary center

Abstract

Background/Aim: Abdominal computed tomography (ACT) is a frequently used imaging modality. The large imaging area often results in the inclusion of lower sections of the thorax. It is known that some thoracic pathologies have symptoms that mimic upper abdominal pathologies. It is possible to detect many pathologies with careful examination of these levels. Previous studies have been conducted to detect incidental chest findings in imaging methods performed for emergency reasons such as trauma, but there is no study in the literature investigating incidental chest findings in ACT imaging. The aim of this study is to determine the incidental findings detected in thoracic sections included in abdominal computed tomography (CT) images and the prevalence of these findings in a tertiary center. Methods: This descriptive study includes 1133 patients who were admitted to Adıyaman Training and Research Hospital between 2017-2020 due to abdominal pain, diarrhea, vomiting, weight loss, constipation, and recurrent urinary tract infection, and underwent abdominal CT scanning. The necessary local ethics committee approval was obtained. Incidental findings in thoracic areas shown in the abdominal CT images included mediastinal findings, infectious findings, pulmonary lesions, pleural findings, lung parenchyma and pleural findings. Results: The mean age of the patients was 43.8 (18.7) years. Incidental findings were detected in 49.2% of the patients, the most common being those related to the lung parenchyma and the pleura (20.7%). The most common lung lesions were pulmonary nodules smaller than 1 cm (5%). In addition, 116 (10.2%) patients had infectious findings, among which the images of 31 (2.7%) suggested bacterial pneumonia factors, and 17 (1.5%) had interstitial pneumonia findings due to the SARS-CoV2 virus. Conclusion: According to the results of this study, evaluation of pathologies detected incidentally in the thorax in ACT sections may affect the treatment of patients. In addition, evaluation, follow-up, and early treatment of lung nodules that can be detected incidentally can prevent possible advanced stage malignancies. Although the symptoms and clinical statuses of the patients are very useful in evaluating the images, examination of every structure included in the imaging field may play a role in the early diagnosis and treatment of some pathologies.