Prevalence of noncardiac findings on clinical cardiovascular MRI

The purpose of our study was to determine the prevalence and significance of noncardiac findings on clinical cardiovascular MRI and to identify the cardiovascular MRI sequences that most frequently depict noncardiac findings.

Images from 495 clinical cardiovascular MRI studies performed during 2006 were reviewed specifically for noncardiac findings by a cardiovascular imaging fellowship-trained radiologist without knowledge of the prior study interpretation. Noncardiac findings were classified as benign (e.g., gynecomastia), indeterminate (e.g., pleural effusion), or worrisome (e.g., lung nodule). The cardiovascular MRI sequences depicting the noncardiac finding were recorded.

On image review, 295 noncardiac findings were identified in 212 (43%) of 495 studies, including 148 benign, 133 indeterminate, and 14 worrisome noncardiac findings. Of these, 47% of indeterminate and 57% of worrisome noncardiac findings were not previously known. Cardiovascular MRI sequences that most frequently showed noncardiac findings included the single-shot fast steady-state free precession (SSFP) scout images (63% of all noncardiac findings) and axial T1-weighted fast spin-echo thoracic images (60% of all noncardiac findings), with 99% of management-changing noncardiac findings visualized on one of these two sequences.

Noncardiac findings on clinical cardiovascular MRI are common. Although only a small minority of studies contain management-changing noncardiac findings, the vast majority of management-changing noncardiac findings are seen on thoracic SSFP scout and axial T1-weighted thoracic fast spin-echo images.