Portal circulation aneurysms: Two case reviews

Venous aneurysms of the superior mesenteric vein and portal vein are an uncommon occurrence and often an incidental finding. They can also be associated with hepatocellular disease and portal hypertension. We present CT and ultrasound findings of these entities. The management of venous aneurysms is generally conservative with serial imaging.     

Prevalence of significant extracoronary findings on multislice CT coronary angiography examinations and coronary artery calcium scoring examinations

The purpose of the study was to review the prevalence of significant extracoronary findings in patients who underwent multislice CT coronary angiography examinations and coronary artery calcium scoring examinations. We reviewed the reports of 295 consecutive patients who underwent multislice CT coronary angiography examinations and 140 consecutive patients who had separate coronary calcium scoring examinations from September 2004 to March 2006 in our department's radiology information system. Additional investigations carried out as a result of these findings were also recorded. Fifty-six (19%) out of 295 patients had significant extracoronary findings on coronary CT angiography requiring clinical or radiological follow up. There were 60 significant extracoronary findings. These included 24 patients who had pulmonary abnormalities, 4 who had mediastinal abnormalities, 20 who had upper abdominal abnormalities and 5 who had non-coronary cardiac abnormalities. Three patients had both pulmonary and upper abdominal abnormalities. Eleven (8%) out of 140 patients had significant pulmonary, breast, mediastinal, upper abdominal and cardiac abnormalities on coronary artery calcium scoring examinations, yielding a total of 12 significant findings. In our experience, 19% of the patients who underwent multislice CT coronary angiography and 8% of the patients who underwent coronary artery calcium scoring examinations had significant extracoronary findings requiring follow up. It is therefore imperative for the reporting physician to review the entire examination after the coronary arteries have been assessed. The prevalence of extracoronary findings on these examinations may be of significance, resulting in additional 'hidden costs' if widespread 'screening' is adopted.     

Maxillary sinus unilateral aplasia as an incidental finding following cone‐beam computed (volumetric) tomography

This paper presents a case of maxillary sinus unilateral aplasia, an uncommon condition in adults, diagnosed as an incidental finding during cone‐beam computed tomography (CBCT) examination for an endodontic case analysis. The patient was referred to a specialist endodontic practice for management of an upper right central incisor tooth. A CBCT scan was performed. The images of the left maxillary sinus showed a total lack of pneumatisation, prompting the diagnosis of aplasia. The patient's otolaryngologist was made aware of the findings. Clinical evaluation of volumetric images should be performed by an adequately trained dentist or radiologist so the maximum amount of information is gathered for the patient. This requires a systematic approach to ensure that no relevant information is missed and should include the paranasal sinuses and other surrounding structures as incidental findings can be observed during CBCT analysis.     

Managing clinically significant findings in research: the UK10K example

Recent advances in sequencing technology allow data on the human genome to be generated more quickly and in greater detail than ever before. Such detail includes findings that may be of significance to the health of the research participant involved. Although research studies generally do not feed back information on clinically significant findings (CSFs) to participants, this stance is increasingly being questioned. There may be difficulties and risks in feeding clinically significant information back to research participants, however, the UK10K consortium sought to address these by creating a detailed management pathway. This was not intended to create any obligation upon the researchers to feed back any CSFs they discovered. Instead, it provides a mechanism to ensure that any such findings can be passed on to the participant where appropriate. This paper describes this mechanism and the specific criteria, which must be fulfilled in order for a finding and participant to qualify for feedback. This mechanism could be used by future research consortia, and may also assist in the development of sound principles for dealing with CSFs.