Extra-cardiac findings in cardiovascular magnetic resonance: what the imaging cardiologist needs to know

• Published in: Journal of cardiovascular magnetic resonance 2016-05, Vol.18 (1), p.26-26, Article 26
• Main Authors: Rodrigues, Jonathan C L, Lyen, Stephen M, Loughborough, William, Amadu, Antonio Matteo, Baritussio, Anna, Dastidar, Amardeep Ghosh, Manghat, Nathan E, Bucciarelli-Ducci, Chiara
• Format: Article
• Language: English
• Subjects: Cardiologists; Cardiovascular Diseases - diagnostic imaging; Clinical Competence; Evaluation; Health Knowledge, Attitudes, Practice; Humans; Incidental Findings; Magnetic Resonance Imaging; Methods; Practice; Practice guidelines (Medicine); Predictive Value of Tests; Prognosis; Reproducibility of Results; Review
• ISSN: 1097-6647; 1532-429X
• DOI: 10.1186/s12968-016-0246-1

Cardiovascular magnetic resonance (CMR) is an established non-invasive technique to comprehensively assess cardiovascular structure and function in a variety of acquired and inherited cardiac conditions. A significant amount of the neck, thorax and upper abdomen are imaged at the time of routine clinical CMR, particularly in the initial multi-slice axial and coronal images. The discovery of unsuspected disease at the time of imaging has ethical, financial and medico-legal implications. Extra-cardiac findings at the time of CMR are common, can be important and can change clinical management. Certain patient groups undergoing CMR are at particular risk of important extra-cardiac findings as several of the cardiovascular risk factors for atherosclerosis are also risk factors for malignancy. Furthermore, the presence of certain extra-cardiac findings may contribute to the interpretation of the primary cardiac pathology as some cardiac conditions have multi-systemic extra-cardiac involvement. The aim of this review is to give an overview of the type of extra-cardiac findings that may become apparent on CMR, subdivided by anatomical location. We focus on normal variant anatomy that may mimic disease, common incidental extra-cardiac findings and important imaging signs that help distinguish sinister pathology from benign disease. We also aim to provide a framework to the approach and potential further diagnostic work-up of incidental extra-cardiac findings discovered at the time of CMR. However, it is beyond the scope of this review to discuss and determine the clinical significance of extracardiac findings at CMR.