Early detection and treatment of coronary artery disease (CAD) can reduce incidences of acute myocardial infarction. In this study, we determined the proper use of contributing risk factors and coronary artery calcium score (CACS) when screening asymptomatic patients with coronary arterial stenoses using coronary computed tomography angiography (CCTA). We reviewed 934 consecutive patients who received CACS and CCTA between December 2013 and November 2016. At least one cardiovascular disease risk factor was present in each of the 509 asymptomatic participants. Patients were grouped based on CACS into “zero,” “minimal” (0 < CACS ≤ 10), “mild” (10 < CACS ≤ 100), “moderate” (100 < CACS ≤ 400), and “excessive” (CACS > 400). Males over 45 years old with diabetes mellitus and hypertension had a higher risk of significant coronary stenosis. In multivariate analysis, age, sex, hypertension, and diabetes mellitus remained significant predictors of stenosis. A CACS of zero occurred in 227 patients (44.6%). There were no significant differences between the “zero” and “minimal” groups (p = 0.421), but the “mild,” “moderate,” and “excessive” groups showed correlations with significant coronary stenosis. Age, sex, diabetes mellitus, and hypertension were associated with higher risk of significant coronary stenosis. Asymptomatic patients with CACSs of zero do not require CCTA, and thereby avoid unnecessary radiation exposure.

Renal cysts are common incidental findings in clinical practice. Most renal cysts detected in medical imaging are benign simple cysts. However, some are complicated by hemorrhage or infection or are associated with calcification. In these instances, difficulties can be encountered distinguishing the complicated cysts from cystic renal tumors such as cystic renal cell carcinoma, multilocular cystic nephroma, and mixed epithelial and stromal tumors. The Bosniak classification is widely used to categorize cystic renal lesions but is used to classify those discovered via computed tomography. Ultrasonography (US) and color Doppler US are the most frequently used imaging techniques for abdominal surveys and long-term follow-up because of their noninvasiveness, relatively low cost, wide availability, and frequently, lack of contrast medium. Herein, we review the features of various cystic lesions of the kidney that can be found using US, discuss differential diagnoses using US, and propose a feature-oriented algorithmic approach to classifying renal cystic lesions using US.

The combination of four US features of Category 1 nodules is highly predictive of benign disease, and we could avoid unnecessary US-guided FNA in 69.5% of our patients using this combined features.