Extracardiac findings at cardiac MR imaging: a single-centre retrospective study over 14 years

Abstract

Objectives

To determine the prevalence and significance of extracardiac findings (ECF) in a large set of cardiac magnetic resonance (MR) imaging examinations.

Methods

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.

Results

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).

Conclusion

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.

Key Points

• 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.