title: Incidental extracardiac findings on cardiac MR: Systematic review and meta-analysis.
abstract: OBJECTIVE
  To perform a systematic review and meta-analysis to calculate the pooled prevalence of incidental extracardiac findings (IEFs) on cardiac magnetic resonance (MR) and to determine factors influencing reported prevalences.
  
  
  METHODS
  We examined studies published in the literature using the MEDLINE database. Studies reporting IEFs on cardiac MR were included. Meta-analysis provided pooled prevalences of total, minor, major IEFs, and major IEFs with patient management changes using a random-effects model. Heterogeneity and inconsistency (I-squared) between studies as well as publication bias were assessed.
  
  
  RESULTS
  Twelve studies including 7062 patients (mean age: 52 years, range: 0.5-93 years, 4476 male/2586 female) and 7122 cardiac MR examinations were considered in the meta-analysis. Overall, the pooled prevalence of total IEFs was 35% (95% confidence interval [CI]: 23-47%). The pooled prevalence of minor and major IEFs were 17% (95% CI: 9-26%) and 12% (95% CI: 7-18%), respectively. Newly diagnosed major IEFs changed patient management in 1% (95% CI: 1-2%) of the study population. A high heterogeneity and inconsistency (I-squared >74%) between studies without publication bias were observed, notably due to IEFs recording method (P < 0.002) and formal training of cardiac MR readers (P < 0.006).
  
  
  CONCLUSIONS
  Major IEFs may be found in 12% of patients undergoing cardiac MR examination and change the management in 1% of patients. Readers' training for the evaluation of noncardiac structures increases reported prevalence.
authors.affiliation: Department of Radiodiagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Vincent
authors.initials: V
authors.lastname: Dunet
authors.affiliation: Cardiac MR Center, Lausanne University Hospital, Lausanne, Switzerland.|Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Juerg
authors.initials: J
authors.lastname: Schwitter
authors.affiliation: Department of Radiodiagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland.|Cardiac MR Center, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Reto
authors.initials: R
authors.lastname: Meuli
authors.affiliation: Department of Radiodiagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland.|Cardiac MR Center, 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; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging* / Q000502:physiology; D006801:Humans; D033162:Incidental Findings; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D015995:Prevalence; D015203:Reproducibility of Results; D055815:Young Adult
keywords: cardiac imaging; incidental findings; magnetic resonance imaging; meta-analysis