Chaosuwannakit Narumol, Makarawate Pattarapong
Radiology Department, Khon Kaen University, Khon Kaen, Thailand.
Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Kardiochir Torakochirurgia Pol. 2018 Dec;15(4):241-245. doi: 10.5114/kitp.2018.80921. Epub 2018 Dec 31.
Incidental pathological findings are frequently found outside the investigated cardiovascular system in cardiac magnetic resonance (CMR) imaging. Some of these findings might have clinical importance.
To evaluate the prevalence and significance of extracardiac findings (ECFs) in patients referred for CMR. The CMR has the ability to depict ECFs in the visualized thorax and upper abdomen. These incidental lesions can often present a challenge to physicians.
A total of 192 CMR reports were retrospectively reviewed for extracardiac findings. ECFs were classified as benign, indeterminate, or of clinical significance at the time of image evaluation. Benign findings were those considered to be of little clinical significance with no follow-up needed. Indeterminate findings were those deemed of potential clinical importance, requiring correlation of the patient history or a follow-up study. Clinically significant findings were those felt to be of definite clinical importance requiring immediate evaluation or intervention.
A total of 56 (29.2%) ECFs were found in 192 (29.2%) patients. Of those, 21 (37.5%) were considered benign, 23 (41%) indeterminate, and 12 (21.4%) clinically significant findings. In the clinically significant group, the most common findings were liver and pulmonary masses. Five malignancies were observed with certainty at CMR. All of them had been incidentally diagnosed on CMR for the first time, and the patients' management was subsequently changed.
Extracardiac findings in clinically indicated CMR are common in the present study (about 29.2%). Radiologists and cardiologists should be aware of relevant extracardiac findings that might require additional diagnostics or treatment.
在心脏磁共振成像（CMR）中，偶然的病理发现经常出现在被检查的心血管系统之外。其中一些发现可能具有临床意义。
评估因CMR检查而就诊的患者中心外发现（ECF）的发生率和意义。CMR能够描绘可视化胸部和上腹部的ECF。这些偶然发现的病变常常给医生带来挑战。
回顾性分析192份CMR报告，以查找心外发现。在图像评估时，将ECF分为良性、不确定或具有临床意义。良性发现是那些被认为临床意义不大且无需随访的发现。不确定发现是那些被认为具有潜在临床重要性、需要结合患者病史或进行随访研究的发现。具有临床意义的发现是那些被认为具有明确临床重要性、需要立即评估或干预的发现。
在192例患者（29.2%）中总共发现了56例（29.2%）ECF。其中，21例（37.5%）被认为是良性的，23例（41%）为不确定的，12例（21.4%）为具有临床意义的发现。在具有临床意义的组中，最常见的发现是肝脏和肺部肿块。在CMR检查中确定观察到5例恶性肿瘤。所有这些都是首次在CMR检查中偶然诊断出来的，随后患者的治疗方案发生了改变。
在本研究中，临床指征性CMR检查中的心外发现很常见（约29.2%）。放射科医生和心脏病专家应了解可能需要额外诊断或治疗的相关心外发现。
