Impact of Extracardiac Findings during Cardiac MR on Patient Management and Outcome

Background: Cardiac magnetic resonance (CMR) is increasingly used to assess heart diseases. Relevant non-cardiac diseas-es may also be incidentally found on CMR images. The aim of this study was to determine the prevalence and nature of incidental extra-cardiac findings (IEF) and their clinical impact in non-selected patients referred for CMR. Material/Methods: MR images of 762 consecutive patients (515 men, age: 56±18 years) referred for CMR were prospectively inter-preted by 2 radiologists blinded for any previous imaging study. IEFs were classified as major when requiring treatment, follow-up, or further investigation. Clinical follow-up was performed by checking hospital informa-tion records and by calling referring physicians. The 2 endpoints were: 1) non-cardiac death and new treatment related to major IEFs, and 2) hospitalization related to major IEFs during follow-up. Results: Major IEFs were proven in 129 patients (18.6 % of the study population), 14 % of those being unknown before CMR. During 15±6 month follow-up, treatment of confirmed major IEFs was initiated in 1.4%, and no non-car-diac deaths occurred. Hospitalization occurred in 8 patients (1.0 % of the study population) with confirmed ma-jor IEFs and none occurred in the remaining 110 patients with unconfirmed/unexplored major IEFs (p<0.001). Conclusions: Screening for major IEFs in a population referred for routine CMR changed management in 1.4 % of patients. Major IEFs unknown before CMR but without further exploration, however, carried a favorable prognosis ove