Chan Peter G, Smith Martin P, Hauser Thomas H, Yeon Susan B, Appelbaum Evan, Rofsky Neil M, Manning Warren J
Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
JACC Cardiovasc Imaging. 2009 Aug;2(8):980-6. doi: 10.1016/j.jcmg.2009.04.014.
We sought to determine the prevalence of noncardiac pathology in a large consecutive series of patients referred for clinical cardiac magnetic resonance (CMR) studies.
The imaging field for many CMR sequences extends outside of the heart border. As a result, noncardiac pathology may be identified. These noncardiac findings have clinical significance because they often lead to subsequent imaging/testing and intervention. The prevalence of noncardiac findings on clinical CMR studies has not been well described.
The reports of all 1,534 (62% male, age 50 +/- 15 years) clinical CMR studies performed at an academic medical center during calendar years 2002 to 2006 were reviewed. All studies had been interpreted by both a staff cardiologist (level III trained in CMR) and a board-certified radiologist (with fellowship training in CMR). For each study, sex, age, indication for CMR study, and reported noncardiac pathology were extracted. Follow-up for each major noncardiac pathology was evaluated by reviewing the patient's medical center electronic medical record. These noncardiac pathologies were then categorized as significant if an intervention or change in the patient's management ensued.
A total of 116 (7.6%) studies had at least one noncardiac finding. These findings included 55 major findings (e.g., lymphadenopathy, lung abnormalities, mediastinal masses) in 48 distinct reports (prevalence of 3.1%) and 74 minor findings (e.g., small pleural effusions, liver cysts, renal cysts) in 70 distinct reports (prevalence of 4.6%). The majority (62%) of major findings were previously known, with only 8 findings in 6 (0.4%) of 1,534 reports ultimately deemed to be new and clinically important/significant. The age of those with noncardiac pathology was greater (54 +/- 16 years vs. 49 +/- 16 years, p < 0.001).
In this large series of consecutive clinical CMR studies interpreted by both staff cardiologists and radiologists, noncardiac pathology is uncommonly reported. When reported, the majority of major findings are previously known. New major findings were detected in <0.5% of reports.
我们试图确定在一大组连续接受临床心脏磁共振（CMR）检查的患者中非心脏病变的患病率。
许多CMR序列的成像范围超出心脏边界。因此，可能会发现非心脏病变。这些非心脏检查结果具有临床意义，因为它们常常会导致后续的成像检查/测试及干预。临床CMR检查中非心脏检查结果的患病率尚未得到充分描述。
回顾了2002年至2006年在一家学术医疗中心进行的所有1534例（男性占62%，年龄50±15岁）临床CMR检查报告。所有检查均由一名心内科医生（接受过CMR三级培训）和一名获得委员会认证的放射科医生（接受过CMR专项培训）解读。对于每项检查，提取性别、年龄、CMR检查指征以及报告的非心脏病变情况。通过查阅患者的医疗中心电子病历评估每种主要非心脏病变的随访情况。如果随后对患者的管理进行了干预或改变，则将这些非心脏病变归类为有意义。
共有116例（7.6%）检查至少有一项非心脏检查结果。这些结果包括48份不同报告中的55项主要结果（如淋巴结病、肺部异常、纵隔肿块）（患病率为3.1%）以及70份不同报告中的74项次要结果（如少量胸腔积液、肝囊肿、肾囊肿）（患病率为4.6%）。大多数（62%）主要结果是先前已知的，在1534份报告中，只有6份（0.4%）报告中的8项结果最终被认为是新的且具有临床重要性/意义。有非心脏病变患者的年龄更大（54±16岁对49±16岁，p<0.001）。
在这一大组由心内科医生和放射科医生共同解读的连续临床CMR检查中，非心脏病变的报告并不常见。当报告有非心脏病变时，大多数主要结果是先前已知的。在<0.5%的报告中检测到新的主要结果。
