title: Impact of extracardiac findings during cardiac MR on patient management and outcome.
abstract: BACKGROUND
  Cardiac magnetic resonance (CMR) is increasingly used to assess heart diseases. Relevant non-cardiac diseases may also be incidentally found on CMR images. The aim of this study was to determine the prevalence and nature of incidental extra-cardiac findings (IEF) and their clinical impact in non-selected patients referred for CMR.
  
  
  METHODS
  MR images of 762 consecutive patients (515 men, age: 56±18 years) referred for CMR were prospectively interpreted by 2 radiologists blinded for any previous imaging study. IEFs were classified as major when requiring treatment, follow-up, or further investigation. Clinical follow-up was performed by checking hospital information records and by calling referring physicians. The 2 endpoints were: 1) non-cardiac death and new treatment related to major IEFs, and 2) hospitalization related to major IEFs during follow-up.
  
  
  RESULTS
  Major IEFs were proven in 129 patients (18.6% of the study population), 14% of those being unknown before CMR. During 15±6 month follow-up, treatment of confirmed major IEFs was initiated in 1.4%, and no non-cardiac deaths occurred. Hospitalization occurred in 8 patients (1.0% of the study population) with confirmed major IEFs and none occurred in the remaining 110 patients with unconfirmed/unexplored major IEFs (p<0.001).
  
  
  CONCLUSIONS
  Screening for major IEFs in a population referred for routine CMR changed management in 1.4% of patients. Major IEFs unknown before CMR but without further exploration, however, carried a favorable prognosis over a follow-up period of 15 months.
authors.affiliation: Department of Radiology, Division of Radiodiagnostics and interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Vincent
authors.initials: V
authors.lastname: Dunet
authors.affiliation: Department of Radiology, Division of Radiodiagnostics and interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Heloise
authors.initials: H
authors.lastname: Barras
authors.affiliation: Department of Radiology, Division of Radiodiagnostics and interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Xavier
authors.initials: X
authors.lastname: Boulanger
authors.affiliation: Cardiac MR Center, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Pierre
authors.initials: P
authors.lastname: Monney
authors.affiliation: Department of Radiology, Division of Radiodiagnostics and interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Salah D
authors.initials: SD
authors.lastname: Qanadli
authors.affiliation: Department of Radiology, Division of Radiodiagnostics and interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Reto
authors.initials: R
authors.lastname: Meuli
authors.affiliation: Cardiac MR Center, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Juerg
authors.initials: J
authors.lastname: Schwitter
authors.affiliation: Department of Radiology, Division of Radiodiagnostics and interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Catherine
authors.initials: C
authors.lastname: Beigelman-Aubry
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D005260:Female; D006760:Hospitalization; D006801:Humans; D033162:Incidental Findings; D007223:Infant; D007674:Kidney Diseases / Q000175:diagnosis / Q000473:pathology; D008107:Liver Diseases / Q000175:diagnosis / Q000473:pathology; D008171:Lung Diseases / Q000175:diagnosis / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011446:Prospective Studies; D016037:Single-Blind Method; D013122:Spinal Diseases / Q000175:diagnosis / Q000473:pathology; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult