Practical approach to extracardiac findings in CT and MR for the non-radiologist

Cross-sectional cardiac imaging plays an essential role in the evaluation of pediatric patients with congenital and acquired heart disease. While the focus of cardiac imaging is primarily on evaluating cardiac structures, it also provides valuable insights into extracardiac structures and associated abnormalities. The radiologists and cardiologists interpreting these exams play a critical role in recognizing these findings and providing recommendations for follow-up testing when indicated. Due to the excellent soft tissue resolution of cardiac magnetic resonance imaging (MRI) and computed tomography (CT), incidental findings can often be diagnosed without further imaging. Incidental findings are generally defined as lesions or masses detected by imaging that is performed for a different reason. In other cases, further imaging evaluation and testing may be necessary. This article aims to explore the spectrum of extracardiac findings encountered in pediatric cardiac imaging studies, their clinical significance, and the potential implications for patient care.