title: Non-cardiovascular findings in clinical cardiovascular magnetic resonance imaging in children.
abstract: BACKGROUND
  With increasing use of pediatric cardiovascular MRI, it is important for all imagers to become familiar with the spectrum of non-cardiovascular imaging findings that can be encountered.
  
  
  OBJECTIVE
  This study aims to ascertain the prevalence and nature of these findings in pediatric cardiovascular MRIs performed at our institution.
  
  
  METHODS
  We retrospectively evaluated reports of all cardiovascular MRI studies performed at our institute from January 2008 to October 2012 in patients younger than18 years. Most studies (98%) were jointly interpreted by a pediatric cardiologist and a radiologist. We reviewed the electronic medical records of all cases with non-cardiovascular findings, defined as any imaging finding outside the cardiovascular system. Non-cardiovascular findings were classified into significant and non-significant, based on whether they were known at the time of imaging or they required additional workup or a change in management.
  
  
  RESULTS
  In 849 consecutive studies (mean age 9.7 ± 6.3 years), 145 non-cardiovascular findings were found in 140 studies (16.5% of total studies). Overall, 51.0% (74/145) of non-cardiovascular findings were in the abdomen, 30.3% (44/145) were in the chest, and 18.6% (27/145) were in the spine. A total of 19 significant non-cardiovascular findings were observed in 19 studies in individual patients (2.2% of total studies, 47% male, mean age 5.9 ± 6.7 years). Significant non-cardiovascular findings included hepatic adenoma, arterially enhancing focal liver lesions, asplenia, solitary kidney, pelvicaliectasis, renal cystic diseases, gastric distention, adrenal hemorrhage, lung hypoplasia, air space disease, bronchial narrowing, pneumomediastinum and retained surgical sponge.
  
  
  CONCLUSIONS
  Non-cardiovascular findings were seen in 16.5% of cardiovascular MRI studies in children, of which 2.2% were clinically significant findings. Prevalence and nature of these non-cardiovascular findings are different from those reported in adults. Attention to these findings is important during interpretation.
authors.affiliation: Department of Radiology, Section of Pediatric Radiology, University of Michigan Health System, C.S. Mott Children's Hospital, 1540 E. Hospital Drive, SPC 4252, Ann Arbor, MI, 48019-4252, USA. maryamg@med.umich.edu.
authors.forename: Maryam Ghadimi
authors.initials: MG
authors.lastname: Mahani
authors.affiliation: Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Ajaykumar C
authors.initials: AC
authors.lastname: Morani
authors.affiliation: Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, University of Michigan Health System, C.S. Mott Children's Hospital, Ann Arbor, MI, USA.
authors.forename: Jimmy C
authors.initials: JC
authors.lastname: Lu
authors.affiliation: Department of Radiology, Section of Pediatric Radiology, University of Michigan Health System, C.S. Mott Children's Hospital, 1540 E. Hospital Drive, SPC 4252, Ann Arbor, MI, 48019-4252, USA.|Department of Graduate Medical Education, Providence Hospital and Medical Centers, Southfield, MI, USA.
authors.forename: Soudabeh Fazeli
authors.initials: SF
authors.lastname: Dehkordy
authors.affiliation: Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.|Department of Radiology, Geisinger Medical Center, Danville, PA, USA.
authors.forename: Sunil
authors.initials: S
authors.lastname: Jeph
authors.affiliation: Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, University of Michigan Health System, C.S. Mott Children's Hospital, Ann Arbor, MI, USA.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Dorfman
authors.affiliation: Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: Prachi P
authors.initials: PP
authors.lastname: Agarwal
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004066:Digestive System Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D033162:Incidental Findings; D007223:Infant; D007231:Infant, Newborn; D019028:Magnetic Resonance Imaging, Cine / Q000706:statistics & numerical data*; D008297:Male; D008824:Michigan / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D013118:Spinal Cord Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D013896:Thoracic Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*
keywords: Children; Congenital heart disease; Heart; Incidental findings; Magnetic resonance imaging