Extracardiac findings detected by cardiac magnetic resonance imaging

Objective To determine the prevalence and importance of extracardiac findings (ECF) in patients undergoing clinical CMR and to test the hypothesis that the original CMR reading focusing on the heart may underestimate extracardiac abnormalities. Methods 401 consecutive patients (mean age 53 years) underwent CMR at 1.5 T. Main indications were ischaemic heart disease ( = 183) and cardiomyopathy ( = 164). All CMR sequences, including scout images, were reviewed with specific attention to ECF in a second reading by the same radiologist who performed the first clinical reading. Potentially significant findings were defined as abnormalities requiring additional clinical or radiological follow-up. Results 250 incidental ECF were detected, of which 84 (34%) had potentially significant ECF including bronchial carcinoma ( = 1), lung consolidation ( = 7) and abdominal abnormalities. In 166 CMR studies (41%) non-significant ECF were detected. The number of ECF identified at second versus first reading was higher for significant (84 vs. 47) and non-significant (166 vs. 36) findings ( < 0.00001). Conclusions About one fifth of patients undergoing CMR were found to have potentially significant ECF requiring additional work-up. The second dedicated reading detected significantly more ECF compared with the first clinical reading emphasising the importance of active search for extracardiac abnormalities when evaluating CMR studies. Key Points Many patients undergoing cardiac MR have significant extracardiac findings (ECF) These impact on management and require additional work-up. Wide review of scout and cine sequences will detect most ECFs. Education of radiologists is important to identify ECFs on CMR studies.