Extracardiac findings at cardiac MR imaging: a single-centre retrospective study over 14 years
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To determine the prevalence and significance of extracardiac findings (ECF) in a large set of cardiac magnetic resonance (MR) imaging examinations.
The institutional review board (IRB) of the Charité approved this retrospective, single-centre study. A total of 4376 cardiac MR imaging reports of 3553 patients (age 37.4 ± 20 years, 60.8 % male) examined from 2000 to 2014 were included. Findings with a recommendation for follow-up were considered “major ECF”. To analyse the association of indication, age and gender with ECF, Poisson regression and computed incidence rate ratios (IRR) were evaluated.
The overall prevalence of ECF was 34% (95% confidence interval [CI] 32.5–35.6%). Major ECF were present in 3.4% (95% CI 2.9–4.1%) while findings that changed patient management were found in 0.9% (95% CI 0.7–1.3%). In the cases of congenital heart disease, ECF prevalence was higher compared to myocarditis (IRR, 6.0; 95% CI 5.1–7.1%; p < 0.001), while the prevalence of major ECF was lower (IRR, 0.2; 95% CI 0.02–0.51%; p < 0.05). Older patient age was associated with more nonvascular ECF (p < 0.001). Female patients had the same probability of having an ECF as male patients (IRR, 1.04; 95% CI 0.95–1.1%; p = 0.43).
ECF in cardiac MR imaging are present in about every third patient while relevant ECF that change patient management can be found in about one out of 100 patients. Our data suggest that it is important to involve well-trained radiologists in reading cardiac MR images, which often reveal ECF if congenital heart disease is the clinical indication.
• Extracardiac findings are present in about every third patient.
• Relevant ECF changing patient management are found in one out of 100 findings.
• Chance of ECF is high in patients with CHD and vascular indications.
KeywordsMagnetic resonance imaging Cardiac imaging technique Chest Extracardiac abnormalities Incidental findings
Congenital heart disease
Institutional review board
Incidence rate ratios
Malignant extracardiac finding
The abstract for this paper was submitted and accepted for the European Congress of Radiology in Vienna 2018. Presentation was held in the new My Thesis in 3 Minutes (MyT3)-Session on 1 March 2018.
Prof. Dewey has received grant support from the Heisenberg Program of the DFG (DE 1361/14-1).
Compliance with ethical standards
The scientific guarantor of this publication is Prof. Dr. Marc Dewey
Conflict of interest
The authors of this manuscript declare relationships with the following companies:
Prof. Dewey has received grant support from the Heisenberg Program of the DFG for a professorship (DE 1361/14-1), the FP7 Program of the European Commission for the randomized multicenter DISCHARGE trial (603266-2, HEALTH-2012.2.4.-2).
Prof. Dewey has received lecture fees from Toshiba Medical Systems, Guerbet, Cardiac MR Academy Berlin and Bayer (Schering-Berlex).
Prof. Dewey is the cardiac section editor of European Radiology.
Institutional master research agreements exist with Siemens Medical Solutions, Philips Medical Systems and Toshiba Medical Systems. The terms of these arrangements are managed by the legal department of Charité – Universitätsmedizin Berlin.
Prof. Dr. Bernd Hamm has received research grants from GE Healthcare, Schering, Siemens Medical Solutions and Toshiba Medical Systems. Speakers Bureau: Siemens Medical Solutions and Schering.
Other authors declared no conflicts of interest.
Statistics and biometry
One of the authors has significant statistical expertise.
Written informed consent was waived by the institutional review board.
Institutional review board approval was obtained.
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