06 May 2015 : Clinical Research
Impact of Extracardiac Findings during Cardiac MR on Patient Management and Outcome
Vincent DunetABCDEF, Heloise BarrasABCDEF, Xavier BoulangerABCDE, Pierre MonneyBCDE, Salah D. QanadliACDEF, Reto MeuliADEF, Juerg SchwitterACDEF, Catherine Beigelman-AubryABCDEFDOI: 10.12659/MSM.893599
Med Sci Monit 2015; 21:1288-1296
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.
MATERIAL AND 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.
Keywords: Adolescent, Aged, 80 and over, Child, Child, Preschool, Disease Management, Hospitalization, Incidental Findings, Kidney Diseases - pathology, Liver Diseases - pathology, Lung Diseases - pathology, Magnetic Resonance Imaging, Myocardium - pathology, Prospective Studies, Single-Blind Method, Spinal Diseases - pathology, young adult
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