Abstract 3421: Non-Cardiac Findings on Clinical Cardiac Magnetic Resonance Imaging are Rare
INTRODUCTION: Incidental findings revealed on thoracic imaging have clinical significance as they often trigger further testing and intervention. The prevalence of non-cardiac (NC) findings on clinical cardiac magnetic resonance imaging (CMR) has not been described. We sought to determine the prevalence of NC findings in a large consecutive series of clinical CMR studies.
METHODS: The reports of all 1534 clinical CMR studies performed at an academic medical center during calendar years 2002–2006 were reviewed. Each study had initially been interpreted by both staff cardiologists (level III trained in CMR) and board certified radiologists. For each study gender, age, indication for CMR, and NC findings were extracted.
RESULTS: Indications for the 1534 studies (62% male, age 10 – 89 years) included one or more of the following: ventricular function [517 (34%)]; pulmonary vein assessment [386 (25%)]; cardio-myopathy [362 (24%)]; valvular disease [252 (16%)]; coronary artery assessment [151 (10%)]; viability [116 (8%)]; congenital heart disease [105 (7%)]; pericardial disease [59 (4%)]; and other [120 (8%)]. A total of 129 NC findings were identified in 116 (7.6%) studies. These included 55 major findings in 50 (3.3%) reports: lymphadenopathy [22 (1.4%)]; lung abnormalities [19 (1.2%)]; mediastinal masses [6 (0.4%)]; breast lesions [4 (0.3%)]; ascites [3 (0.2%)]; and soft tissue masses [1 (0.1%)]. There were 74 minor findings in 70 (4.6%) reports: pleural effusions [30 (2.0%)]; benign liver lesions [15 (1.0%)]; renal cysts [14 (0.9%)]; hiatal hernias [7 (0.5%)]; diaphragmatic abnormalities [2 (0.1%)]; splenic abnormalities [2 (0.1%)]; paraspinal lipomas [2 (0.1%)]; and anomalous vasculature [2 (0.1%)]. The age of those with NC findings was higher (54±16 vs. 49±16 years, p<0.001) with no difference in gender.
CONCLUSION: In this series of 1534 consecutive clinical CMR studies interpreted by both staff cardiologists and radiologists, NC findings were identified in 7.6% of studies; 3.3% of studies had major NC findings. These data have important implications for CMR interpretation and clinical training. Further study is needed to elucidate the impact of detecting incidental findings on clinical practice and patient outcomes.