D. Ifan, Southampton, GB

The lower thorax is incidentally imaged in abdominal CT protocols to ensure adequate coverage of the liver and spleen. The degree of coverage can differ due to variability in patient respiration and anatomy as well as radiographer technique. Although an abdominal CT is not a dedicated form of imaging to comprehensively evaluate the thorax, in some cases a considerable proportion of the lower thorax can be imaged and therefore we are obliged to assess this region. We present a series of unusual, yet significant, basal thoracic pathology diagnosed, or identifiable, on abdominal CT.

Imaging findings OR Procedure findings

The abdominal CT commonly extends sufficiently cranially to include the lower lobes of the lungs, cardiac chambers and lower mediastinum as well as a significant proportion of the lower ribs and thoracic spine. Cardiovascular pathology incidentally diagnosed on abdominal CT at our Trust includes left ventricular thrombus, atrial myxoma, pericardial effusion and a thoraco-abdominal aortic aneurysm. Pulmonary nodules and primary lung malignancies are also identified on evaluation of the lung bases as well as lower lobar pulmonary emboli, empyema and bronchopneumonia. Peripheral pulmonary consolidation can be also be recognised as a manifestation of pulmonary infarct, prompting dedicated CT chest imaging. We must also be aware that lower rib and thoracic vertebral metastases are also potentially identifiable on limited imaging of the chest on abdominal CT.

Conclusion

The abdominal CT offers the opportunity to identify significant thoracic pathology which can prompt further imaging and treatment.

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