Accuracy of dual-source computed tomography coronary angiography: evaluation with a standardised protocol for cardiac surgeons

Abstract

Their comments allow us to report some additional information which was omitted due to space constraints. The mass was studied performing a 3-mm multidetector helical computed tomography (CT) scan, unfortunately without using a bolus tracking technique; an acquisition delay of 40 s, with a flow of 2.5 ml s 1 was applied. Themass appeared to be irregularly necrotic, and no significant arterial enhancement was evaluable (with the limits of the technique used). A critical revision of the acquired images was performed by an expert radiologist, and the hypothetic diagnosis of an encapsulated tumour such as a fibrous tumour or a leiomyosarcoma was addressed first. The possible theoretic utility in this clinical case of a magnetic resonance imaging (MRI), which was not performed, was posteriorly advocated according to the direct multiplanar imaging ofMRI, that, according to some authors [3], could help to delineate the diaphragm in certain anatomic areas that evade delineation on cross-sectional images, thus revealing its position in relation with the tumour. However, we completely agree with the colleagues that this examination is not a first-level tool in the diagnosis of intrathoracic masses, and its use should be reserved to selected cases, when diagnosis is not clear and further details could be important to achieve the correct diagnostic and therapeutic decision.