The use of pre-existing CT imaging in screening for abdominal aortic aneurysms.

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Clinical Guidelines
Authored By
Ruff A, Patel K, Joyce JR, Gornik HL, Rothberg MB
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Cardiology
Emergency Medicine
Radiology
Speciality
Cardiology
Radiology
Emergency Medicine
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volume
21
ISSN
1477-0377
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ISSN
1477-0377
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true
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Additional Info
["Ruff A, Patel K, Joyce JR, Gornik HL, Rothberg MB","Publisher: SAGE Publications Country of Publication: England NLM ID: 9610930 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1477-0377 (Electronic) Linking ISSN: 1358863X NLM ISO Abbreviation: Vasc Med Subsets: MEDLINE","Journal Article","2016-12-01","Vascular medicine (London, England) [Vasc Med] 2016 Dec; Vol. 21 (6), pp. 515-519. Date of Electronic Publication: 2016 May 28.","English","1477-0377","Incidental Findings* , Tomography, X-Ray Computed*, Aortic Aneurysm, Abdominal\/*diagnostic imaging , Mass Screening\/*methods, Aged ; Female ; Humans ; Male ; Ohio ; Predictive Value of Tests ; Reproducibility of Results ; Retrospective Studies ; Unnecessary Procedures","Aged, Female, Humans, Male, Ohio, Predictive Value of Tests, Reproducibility of Results, Retrospective Studies, Unnecessary Procedures, Aortic Aneurysm, Abdominal diagnostic imaging, Incidental Findings, Mass Screening methods, Tomography, X-Ray Computed","Vascular medicine (London, England)","21"]
Description
Ultrasound screening for abdominal aortic aneurysm (AAA) is recommended for male smokers >65 years of age, but screening rates remain low. If computed tomography (CT) performed for other indications could be considered adequate for screening, one-third of ultrasounds would potentially be unnecessary, and overall screening rates would be substantially higher. The objective of this study was to evaluate the sensitivity of CT imaging of the abdomen for the detection of AAA when performed for other clinical indications. We performed a retrospective study of patients eligible for AAA screening who had undergone an abdominal ultrasound as well as an abdominal CT scan for other indications within 3 years prior to that study. The primary outcome was identification of an AAA, recorded in the findings narrative or impression of the CT scan report. Of 142 patients with both a CT scan and an AAA on ultrasound, 127 (89.4%) were noted to have an AAA in the report of a CT scan performed within the 3 years prior to the ultrasound. An additional 10 films demonstrated an AAA that was not mentioned in the report. The sensitivity of pre-existing CT scans for AAA screening was 97.2% (137/141) [95% CI: 93.4-99.0%]; 123 (86.6%) of these positive findings were reported in the findings narrative and 120 (84.5%) were reported in the radiologist's final impression. The sensitivity for AAA identification in the report of a pre-existing CT scan of the abdomen performed for alternate indications appears high enough to use as a screening test. When radiologists note an AAA, they should be sure to include it in the final impression.<br /> (© The Author(s) 2016.)
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