1. J.Calatayud Moscoso del Prado, D.Castellón Plaza, G.Fernández Pérez, N. Silva Priegue, M. Velasco Casares, C. Martínez Rodríguez POVISA Hospital, Vigo (SPAIN) J.Calatayud Moscoso del Prado, D.Castellón Plaza, G.Fernández Pérez, N. Silva Priegue, M. Velasco Casares, C. Martínez Rodríguez POVISA Hospital, Vigo (SPAIN) ECR Vienna, March 2010

2.  To calculate the prevalence of incidental Abdominal-CT features observed on Chest-CT  To establish the effect of these finding and subsequent additional examinations in patient care

3.  272 consecutive Chest-CTs were prospectively reviewed looking for presence of abdominal pathology.

4. CTs were performed from the level of the lung apex to 2cm under level of the diaphragm.

5.  Images were reviewed with soft tissue, lung and bone windows by two radiologist.  Abdominal findings were classified as major, intermediate or minor based upon their impact on patient management.  Follow-up information was obtained after additional examination when available.

6.  MAJOR FINDINGS included indeterminate nodules, lesions that could require relatively prompt medical or surgical treatment;  INTERMEDIATE FINDINGS included lesions that may eventually require medical or surgical intervention;  MINOR FINDINGS included lesions that don't need further intervention;

7. Abdominal findings were detected in 162 (60%) of 272 patients

8. IN TOTAL: 213 INCIDENTAL FINDINGS IN TOTAL: 213 INCIDENTAL FINDINGS 57 4

9.  162 patients had at least one incidental finding.  Of these, 87 patients had one finding, 57 had two findings and 4 had three findings  In total, 213 abdominal findings were detected.

10.  Additional explorations were recommended in 26 patients (9,5%):  17 patients underwent complementary tests diagnosis was confirmed in 15 patients no pathological findings in 2 patients  Incidental findings were already known in 2 patients  Additional test were not performed in 7 patients

15. 40 year-old man remitted by dilated miocardiopathy. Chest-CT revealed a polypoid lesion on gastric body and chronic hepatopathy. We recommended gastroscopy

16. Finally, patient underwent endoscopy biopsy and carcinoyd tumor was the final diagnosis.

17. 53 year-old patient underwent Chest-CT without contrast e.v for suspected bronchopneumonia

18. Abdominal CT with endovenous contrast was performed and HYPERNEPHROMA was confirmed

19. 76 years old man underwent Chest-CT to study of pulmonary mass in left lower lobe demostrated in X-Ray. Chest-CT showed the hiliar mass, splenic lesions and a possible esophageal perforation.

20. As a result patient was diagnosticated with lymphoma by pathological anatomy. Esophageal transit and endoscopy were performed

21. 78 year-old man with constitutional syndrome Chest-CT showed a large mass in the right hepatic lobe

22. Arterial phase Venous phase Arterial and venous phases were performed and patient was diagnosticated of HEPATOCARCINOMA.

23. cholelitiasis Fatty liver and adrenal nodule Fatty liver and diverticulum of transverse colon INTERMEDIATE ABDOMINAL FINDINGS. Examples:

24.  Chest-CT reveal an important number of unsuspected abdominal findings on upper abdomen  Most of them were menor and required further intervention or follow up.  Therefore, it`s of almost importance to look through the lower chest systematically and report these findings in order to improve patient care and avoid unnecessary examinations.

25.  The goal of our study is to asses the prevalence of chest findings at abdomen-CT and to establish the importance of looking at the chest.  It’s important to arrive to a correct diagnosis of an incidental findings and know which of them will require further examinations.