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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
06:29

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques

Published on: June 11, 2019

Extracardiac findings detected by cardiac magnetic resonance imaging

Rolf Wyttenbach1, Nathalie Médioni, Paolo Santini

  • 1Department of Radiology, Ospedale San Giovanni Bellinzona (EOC), CH-6500 Bellinzona, Switzerland. rolf.wyttenbach@bluewin.ch

European Radiology
|January 5, 2012
PubMed

Insights

A second review of cardiac MRI scans revealed significantly more extracardiac findings (ECF) than the initial reading. This highlights the importance of thoroughly examining all cardiac MRI sequences for potentially significant ECF.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Diagnostic Medicine

Background:

  • Cardiac Magnetic Resonance (CMR) is a key imaging modality for cardiac assessment.
  • Incidental extracardiac findings (ECF) are common but may be overlooked in standard cardiac-focused reviews.
  • The clinical significance and detection rates of ECF during CMR warrant further investigation.

Purpose of the Study:

  • To determine the prevalence and clinical importance of ECF in patients undergoing CMR.
  • To evaluate whether a standard cardiac-focused CMR reading underestimates the detection of ECF.
  • To test the hypothesis that a dedicated second reading improves ECF detection.

Main Methods:

  • A retrospective review of 401 consecutive CMR studies (1.5 T) was performed.
  • Indications included ischemic heart disease and cardiomyopathy.
  • A second, dedicated review by the same radiologist focused on identifying all ECF, including scout images, and compared findings with the initial clinical reading.

Main Results:

  • 250 incidental ECF were detected across all studies.
  • 84 ECF (34% of incidental findings) were deemed potentially significant, requiring further work-up.
  • The second dedicated reading identified significantly more ECF (both significant and non-significant) compared to the initial clinical reading (P < 0.00001).

Conclusions:

  • Approximately one-fifth of patients undergoing CMR have potentially significant ECF requiring additional investigation.
  • A dedicated, comprehensive review of CMR sequences, including scout images, significantly increases the detection of ECF.
  • Radiologists should actively search for ECF during CMR interpretation to ensure comprehensive patient assessment.
Abstract

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