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Prevalence and Clinical Relevance of Extracardiac Findings in Cardiovascular Magnetic Resonance Imaging

Mantini, Cesare; Mastrodicasa, Domenico; Bianco, Francesco; Bucciarelli, Valentina; Scarano, Michele; Mannetta, Gianluca; Gabrielli, Daniela; Gallina, Sabina; Petersen, Steffen E. and Ricci, Fabrizio LU , et al. (2019) In Journal of Thoracic Imaging 34(1). p.48-55
Abstract

Purpose: To assess the prevalence of extracardiac findings (ECF) during cardiovascular magnetic resonance (CMR) examinations and their downstream effect on clinical management. Materials and Methods: We retrospectively identified 500 consecutive patients. Trans-axial balanced steady-state free precession nongated images acquired from the upper thorax to the upper abdomen were evaluated independently by 2 radiologists. ECF were classified as nonsignificant (benign, with no need for further investigation), significant (mandatory to be reported/monitored), and major (clinically remarkable pathology, mandatory to be reported/investigated/treated). Fifteen-month clinical follow-up information was collected through hospital records. Results:... (More)

Purpose: To assess the prevalence of extracardiac findings (ECF) during cardiovascular magnetic resonance (CMR) examinations and their downstream effect on clinical management. Materials and Methods: We retrospectively identified 500 consecutive patients. Trans-axial balanced steady-state free precession nongated images acquired from the upper thorax to the upper abdomen were evaluated independently by 2 radiologists. ECF were classified as nonsignificant (benign, with no need for further investigation), significant (mandatory to be reported/monitored), and major (clinically remarkable pathology, mandatory to be reported/investigated/treated). Fifteen-month clinical follow-up information was collected through hospital records. Results: Of 500 patients, 108 (21.6%) showed a total of 153 ECF: 59 (11.8% of the entire study population; 38.5% of all ECF) nonsignificant, 76 (15.2%; 49.7%) significant, and 18 (3.6%; 11.8%) major ECF. The most frequent ECF were pleural effusion, hepatic cyst, renal cyst, and ascending aorta dilatation. Of 94 significant and major ECF, 46 were previously unknown and more common in older patients. Newly diagnosed major ECF (n=11, 2.2% of the entire study population, and 7.2% of all ECF)-including 5 tumors (1% of study population)-were confirmed by downstream evaluations and required specific treatment. Patients with major ECF were significantly older than patients without with major ECF. Newly diagnosed clinically significant and major ECF prompted downstream diagnostic tests in 44% and 100% of cases, respectively. Conclusions: The detection of significant and major ECF is common during CMR reporting. The knowledge and the correct identification of most frequent ECF enable earlier diagnoses and faster treatment initiation of unknown extracardiac pathologies in patients referred to CMR imaging.

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publication status
published
subject
keywords
Cardiac imaging techniques, Incidental findings, Magnetic resonance imaging, Thorax
in
Journal of Thoracic Imaging
volume
34
issue
1
pages
48 - 55
publisher
Lippincott Williams and Wilkins
external identifiers
  • scopus:85052988983
ISSN
0883-5993
DOI
10.1097/RTI.0000000000000360
language
English
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yes
id
a31ac20b-4704-4b05-b3fc-b456e83dc4ff
date added to LUP
2018-10-24 13:17:24
date last changed
2019-02-20 11:33:14
@article{a31ac20b-4704-4b05-b3fc-b456e83dc4ff,
  abstract     = {<p>Purpose: To assess the prevalence of extracardiac findings (ECF) during cardiovascular magnetic resonance (CMR) examinations and their downstream effect on clinical management. Materials and Methods: We retrospectively identified 500 consecutive patients. Trans-axial balanced steady-state free precession nongated images acquired from the upper thorax to the upper abdomen were evaluated independently by 2 radiologists. ECF were classified as nonsignificant (benign, with no need for further investigation), significant (mandatory to be reported/monitored), and major (clinically remarkable pathology, mandatory to be reported/investigated/treated). Fifteen-month clinical follow-up information was collected through hospital records. Results: Of 500 patients, 108 (21.6%) showed a total of 153 ECF: 59 (11.8% of the entire study population; 38.5% of all ECF) nonsignificant, 76 (15.2%; 49.7%) significant, and 18 (3.6%; 11.8%) major ECF. The most frequent ECF were pleural effusion, hepatic cyst, renal cyst, and ascending aorta dilatation. Of 94 significant and major ECF, 46 were previously unknown and more common in older patients. Newly diagnosed major ECF (n=11, 2.2% of the entire study population, and 7.2% of all ECF)-including 5 tumors (1% of study population)-were confirmed by downstream evaluations and required specific treatment. Patients with major ECF were significantly older than patients without with major ECF. Newly diagnosed clinically significant and major ECF prompted downstream diagnostic tests in 44% and 100% of cases, respectively. Conclusions: The detection of significant and major ECF is common during CMR reporting. The knowledge and the correct identification of most frequent ECF enable earlier diagnoses and faster treatment initiation of unknown extracardiac pathologies in patients referred to CMR imaging.</p>},
  author       = {Mantini, Cesare and Mastrodicasa, Domenico and Bianco, Francesco and Bucciarelli, Valentina and Scarano, Michele and Mannetta, Gianluca and Gabrielli, Daniela and Gallina, Sabina and Petersen, Steffen E. and Ricci, Fabrizio and Cademartiri, Filippo},
  issn         = {0883-5993},
  keyword      = {Cardiac imaging techniques,Incidental findings,Magnetic resonance imaging,Thorax},
  language     = {eng},
  number       = {1},
  pages        = {48--55},
  publisher    = {Lippincott Williams and Wilkins},
  series       = {Journal of Thoracic Imaging},
  title        = {Prevalence and Clinical Relevance of Extracardiac Findings in Cardiovascular Magnetic Resonance Imaging},
  url          = {http://dx.doi.org/10.1097/RTI.0000000000000360},
  volume       = {34},
  year         = {2019},
}