4.6 Article

Incidental findings on coronary computed tomography in women with selected reproductive disorders

Journal

INSIGHTS INTO IMAGING
Volume 13, Issue 1, Pages -

Publisher

SPRINGER
DOI: 10.1186/s13244-022-01238-z

Keywords

Polycystic ovary syndrome; Premature ovarian insufficiency; Preeclampsia; Incidental findings; Computed tomography

Funding

  1. Dutch Heart Foundation [2013T083]

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This study aimed to assess the prevalence of incidental findings (IFs) on coronary computed tomography (CCT) in middle-aged women with reproductive disorders such as polycystic ovary syndrome, premature ovarian insufficiency, or preeclampsia. The study found that 19.8% of women had one or more IFs, some of which required follow-up. The use of a small field of view (FOV) for scanning reduced the prevalence of IFs and the need for follow-up.
Objective To determine the prevalence of incidental findings (IFs) on coronary computed tomography (CCT) in women aged 45-55 years and previously diagnosed with reproductive disorders such as polycystic ovary syndrome (PCOS), premature ovarian insufficiency (POI) or preeclampsia (PE). Methods A total of 486 middle-aged women with PCOS (n = 101), POI (n = 97) or a history of PE (n = 288) underwent a CCT as part of a prior prospective study. IFs were categorized by their significance (minor, moderate and major). Follow-up information was collected from patients' records. To investigate the impact of different field of views (FOVs), a subset of scans was analyzed in full FOV and small FOV. Results In 96/486 (19.8%) women, one or more IFs were detected, of which 54/486 (11.1%) were classified as moderate/major and 48/486 (9.9%) required follow-up. A moderate/major IF was detected in 16/101 (15.9%) women with PCOS, 13/97 (13.4%) women with POI and 25/288 (8.7%) women with a history of PE. In 78 women with an IF detected in the full FOV, the IF was still visible in 60 (76.9%) women in the small FOV. In the full FOV, 46 women required follow-up, but using the small FOV this was reduced to 30 women. Conclusion Using CCT as a cardiovascular disease screening tool in women with selected reproductive disorders increases the probability of detecting IFs that can cause anxiety and may generate extra costs, but can also reveal clinically relevant findings. Using a small FOV centered around the heart resulted in a lower prevalence of IFs and required less follow-up.

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