The use of chest computed tomography (CT) as an imaging test for the evaluation of thoracic pathology has significantly increased during the last four decades. Although cardiopulmonary diseases often overlap in their clinical manifestation, radiologists tend to overlook the heart while interpreting routine chest CT. Recent advances in CT technology have led to significant reduction of heart motion artefacts and now allow for the identification of several cardiac findings on chest CT even without electrocardiogram (ECG) gating. These observations range from simple curiosity to both benign and malignant discoveries, to life-threatening discoveries. We here present a clinical and radiologic review of common and less common cardiac findings discovered on non-gated chest CT in order to draw the attention of radiologists and referring physicians to these possibilities.

lectrocardiography (ECG)-gated multidetector-rowcomputed tomography (MDCT) has developed remarkably in the past several years, with improvements in spatial and temporal resolution. [1][2][3] Several studies have focused on its usefulness for assessing the coronary artery lumen, and others studies have demonstrated its capability to evaluate coronary plaques, so the technique has gained acceptance as a valuable tool for coronary imaging in the clinical setting. [4][5][6][7][8][9][10][11] Because of the retrospective acquisition, the same data acquired for coronary computed tomography (CT) imaging can also be reconstructed over a cardiac cycle, allowing dynamic cardiac imaging; and we recently reported that wall motion and systolic thickening could be accurately estimated as functional parameters. 12-14 ECG-gated MDCT technology can therefore evaluate cardiac blood flow from virtually any perspective, including important angles for the interventional approach and for myocardial perfusion.Of these potential applications of cardiac MDCT, myocardial perfusion has so far been less investigated, but its assessment is important for the diagnosis of ischemia and infarction, and for the therapeutic strategy and follow-up. An evaluation of myocardial blood flow (MBF) is also important for studying the pathophysiology of the disease process. A few studies have reported the utility of cardiac MDCT to qualitatively assess myocardial perfusion using a late-enhancement protocol and the adenosine triphosphate (ATP) load technique, [15][16][17][18][19] but quantitative evaluation studies have not been carried out.Therefore, in this study, we investigated the feasibility of cardiac MDCT technology for quantitative assessment of MBF using the ATP-load technique. Methods PatientsFrom April 2006 to May 2007, taking the exclusion criteria into account, 14 patients (11 men, 3 women, age range 52-79 years, mean 69.2 years) underwent ATP-provocation contrast enhanced MDCT, stress thallium-201 myocardial perfusion scintigraphy (MPS), and conventional coronary angiography (CAG). The entry criteria were: (i) de novo effort or rest angina (documented ST-T change on ECG, or relieved by administration of nitroglycerin); (ii) no history of CAG; and (iii) asymptomatic patients with a high probability of coronary artery disease (CAD) (ie, multiple coronary risk factors) or abnormal findings on stress ECG and single-photon emission computed tomography (SPECT). The ATP-load cardiac CT and CAG had an average 40-day interval, and the ATP-load cardiac CT and MPS inspection had an average interval of 29.2 days. Patient characteristics are shown in Table 1. No patient had a history of previous myocardial infarction (MI) and there were no significant differences between men and women in age, clinical symptoms and coronary risk factors.Circ J 2008; 72: 1086 -1091 (Received November 21, 2007; revised manuscript received February 5, 2008; accepted February 7, 2008

We report an unusual case of spontaneous ovarian hyperstimulation syndrome and pituitary hyperplasia mimicking macroadenoma in an adult, non-pregnant woman. Her condition was triggered by unrecognized primary hypothyroidism, which regressed after thyroid hormone replacement therapy. This case highlights the need for clinicians and radiologists to familiarize themselves with the clinical and imaging features detected in case of these complications of primary hypothyroidism, which are not well known in the medical and radiological profession. Such improved knowledge will help avoid delays in diagnosis, progression to lifethreatening complications, and unnecessary surgery.

MDCT is a feasible method to assess regional LV wall thickness and systolic thickening.