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The prevalence of incidental findings at cardiac MRI.

McKenna DA, Laxpati M, Colletti PM - Open Cardiovasc Med J (2008)

Bottom Line: Remaining findings were considered clinically insignificant.A total of 224 incidental findings were visualized, with at least one clinically significant and moderately significant finding found in 23 (17%) and 43 (33 %) of the subjects, respectively.We believe that these numbers appear high compared to prior similar studies performed at Cardiac CT.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Keck School of Medicine, University of Southern California, USA.

ABSTRACT

Unlabelled: OBJECT OR PURPOSE OF STUDY: As the field of view of cardiac magnetic resonance imaging (CMR) includes the thorax and upper abdomen, it is not surprising that these studies can reveal incidental extra-cardiac abnormalities. The purpose of this study is to determine the prevalence of these incidental findings.

Materials, methods and procedures: 132 volunteer participants with a mean age of 74.2 years (range, 61-89 years; 127 males and 5 females) had CMR with 7 sequences. All images were retrospectively reviewed by a radiologist, specifically assessing for non-cardiac findings. Visualized abnormalities were noted and categorized according to significance. Clinically significant findings were defined as those requiring further clinical or radiological work-up, with moderately significant findings defined as those that may affect patient care depending on medical history or symptoms. Remaining findings were considered clinically insignificant.

Results: Within the group, 107 participants (81%) had extra-cardiac findings, with 63 (48%) having multiple findings. A total of 224 incidental findings were visualized, with at least one clinically significant and moderately significant finding found in 23 (17%) and 43 (33 %) of the subjects, respectively. Potentially clinically significant findings included pulmonary nodules, solid or complex lesions of the solid abdominal viscera and thyroid, and aortic pathology including aneurysm. The most prevalent incidental findings were however benign appearing, including renal and hepatic cysts, hemangiomas, and atelectasis. The SSFP coronal localizer, SSFP axial localizer, and short axis SSFP cine oblique sequences were most sensitive at detecting incidental findings (p = 0.013 vs four other sequences) with 47%, 46%, and 41% detection respectively, with no significant difference between these three multislice sequences (p = 0.369).

Significance of the conclusions: In total, 81% of our volunteers had extra-cardiac findings, of which 17% were potentially clinically significant, necessitating further work up. We believe that these numbers appear high compared to prior similar studies performed at Cardiac CT. This may be related to the relatively older cohort examined here. In conclusion it is important to look beyond the heart when reviewing cardiac MRI studies and carefully assess the entire field of view for abnormalities.

No MeSH data available.


Related in: MedlinePlus

SSFP coronal localizer: multiple enlarged paratracheal, aorto-pulmonary window, coronal, Hilar, and axillary lymph nodes (arrowheads). 70 year old man with sarcoidosis.
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Figure 5: SSFP coronal localizer: multiple enlarged paratracheal, aorto-pulmonary window, coronal, Hilar, and axillary lymph nodes (arrowheads). 70 year old man with sarcoidosis.

Mentions: Descriptive statistics of mean and range were used to summarize the patient cohort with respect to clinical, MR imaging, and outcome variables. Of the 132 participants, 107 (81 %) had at least one extra cardiac finding, with 48% having multiple findings. A total of 224 incidental findings were visualized, including 25 potentially significant findings and 50 findings of intermediate importance (Table 1a- 1c, Figs. 1-5). The most common significant finding was a pulmonary nodule (5 patients) with the commonest intermediate finding being aortic plaque seen in 20 patients. Significant findings included pulmonary or pleural based nodules, solid or complex renal masses and liver lesions as well as aortic aneurysms. Most incidental findings were likely clinically insignificant; of these, renal cysts, hepatic cysts and hemangiomas, and atelectasis were the most prevalent. The frequency of visualization of extra-cardiac pathology on the various sequences was also compared. In our study, the coronal localizer, axial localizer, and short axis multislice views were the best at detecting incidental findings compared with the single slice VLA cine, trans-mitral flow cine, aortic pulsatility cine, and the 4 slice aorta black blood sequence (p = 0.013). With 47%, 46%, and 41% of all findings visualized on the coronal localizer, axial localizer, and short axis multislice views, respectively, there was no significant difference between these three sequences (p= 0.369) (Table 2).


The prevalence of incidental findings at cardiac MRI.

McKenna DA, Laxpati M, Colletti PM - Open Cardiovasc Med J (2008)

SSFP coronal localizer: multiple enlarged paratracheal, aorto-pulmonary window, coronal, Hilar, and axillary lymph nodes (arrowheads). 70 year old man with sarcoidosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC2570573&req=5

Figure 5: SSFP coronal localizer: multiple enlarged paratracheal, aorto-pulmonary window, coronal, Hilar, and axillary lymph nodes (arrowheads). 70 year old man with sarcoidosis.
Mentions: Descriptive statistics of mean and range were used to summarize the patient cohort with respect to clinical, MR imaging, and outcome variables. Of the 132 participants, 107 (81 %) had at least one extra cardiac finding, with 48% having multiple findings. A total of 224 incidental findings were visualized, including 25 potentially significant findings and 50 findings of intermediate importance (Table 1a- 1c, Figs. 1-5). The most common significant finding was a pulmonary nodule (5 patients) with the commonest intermediate finding being aortic plaque seen in 20 patients. Significant findings included pulmonary or pleural based nodules, solid or complex renal masses and liver lesions as well as aortic aneurysms. Most incidental findings were likely clinically insignificant; of these, renal cysts, hepatic cysts and hemangiomas, and atelectasis were the most prevalent. The frequency of visualization of extra-cardiac pathology on the various sequences was also compared. In our study, the coronal localizer, axial localizer, and short axis multislice views were the best at detecting incidental findings compared with the single slice VLA cine, trans-mitral flow cine, aortic pulsatility cine, and the 4 slice aorta black blood sequence (p = 0.013). With 47%, 46%, and 41% of all findings visualized on the coronal localizer, axial localizer, and short axis multislice views, respectively, there was no significant difference between these three sequences (p= 0.369) (Table 2).

Bottom Line: Remaining findings were considered clinically insignificant.A total of 224 incidental findings were visualized, with at least one clinically significant and moderately significant finding found in 23 (17%) and 43 (33 %) of the subjects, respectively.We believe that these numbers appear high compared to prior similar studies performed at Cardiac CT.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Keck School of Medicine, University of Southern California, USA.

ABSTRACT

Unlabelled: OBJECT OR PURPOSE OF STUDY: As the field of view of cardiac magnetic resonance imaging (CMR) includes the thorax and upper abdomen, it is not surprising that these studies can reveal incidental extra-cardiac abnormalities. The purpose of this study is to determine the prevalence of these incidental findings.

Materials, methods and procedures: 132 volunteer participants with a mean age of 74.2 years (range, 61-89 years; 127 males and 5 females) had CMR with 7 sequences. All images were retrospectively reviewed by a radiologist, specifically assessing for non-cardiac findings. Visualized abnormalities were noted and categorized according to significance. Clinically significant findings were defined as those requiring further clinical or radiological work-up, with moderately significant findings defined as those that may affect patient care depending on medical history or symptoms. Remaining findings were considered clinically insignificant.

Results: Within the group, 107 participants (81%) had extra-cardiac findings, with 63 (48%) having multiple findings. A total of 224 incidental findings were visualized, with at least one clinically significant and moderately significant finding found in 23 (17%) and 43 (33 %) of the subjects, respectively. Potentially clinically significant findings included pulmonary nodules, solid or complex lesions of the solid abdominal viscera and thyroid, and aortic pathology including aneurysm. The most prevalent incidental findings were however benign appearing, including renal and hepatic cysts, hemangiomas, and atelectasis. The SSFP coronal localizer, SSFP axial localizer, and short axis SSFP cine oblique sequences were most sensitive at detecting incidental findings (p = 0.013 vs four other sequences) with 47%, 46%, and 41% detection respectively, with no significant difference between these three multislice sequences (p = 0.369).

Significance of the conclusions: In total, 81% of our volunteers had extra-cardiac findings, of which 17% were potentially clinically significant, necessitating further work up. We believe that these numbers appear high compared to prior similar studies performed at Cardiac CT. This may be related to the relatively older cohort examined here. In conclusion it is important to look beyond the heart when reviewing cardiac MRI studies and carefully assess the entire field of view for abnormalities.

No MeSH data available.


Related in: MedlinePlus