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心脏影像学的临床相关心脏外表现:来自欧洲 MR/CT 注册研究的启示。

Clinically Relevant Extracardiac Findings at Cardiac Imaging: Insights from the European MR/CT Registry.

机构信息

From Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland (L.J.M., M.E., H.A.); Department of Diagnostic and Interventional Radiology, Herzzentrum Leipzig Universitatsklinik, Leipzig, Germany (M.G., R.F.G., C. Lücke); Department of Radiology, University Medical Center Groningen, Groningen, the Netherlands (R.V.); Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Humanitas Research Hospital, Rozzano, Italy (M.F.); IRCCS Humanitas Research Hospital, Milan, Italy (M.F.); Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, the Netherlands (R.P.J.B.); Department of Radiology, Antwerp University Hospital and Antwerp University, Antwerp, Belgium (R.S.); Department of Diagnostic and Interventional Radiology, University Hospital Centre Zagreb, Zagreb, Croatia (M.H.P.); Department of Radiology, University Medical Centre Maribor, Maribor, Slovenia (M.P.); Department of Biomedical Imaging and Image-Guided Therapy, Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Vienna, Austria (C. Loewe); Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany (K.N.); British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom (M.C.W.); School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy (G.M.); Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy (G.M.); and Department of Radiological Sciences-Institute of Radiology, Catholic University of Rome, A. Gemelli University Hospital, Rome, Italy (L.N.).

出版信息

Radiol Cardiothorac Imaging. 2024 Oct;6(5):e240117. doi: 10.1148/ryct.240117.

Abstract

Purpose To determine the prevalence of clinically relevant extracardiac findings at cardiac CT and MRI examinations from a multicenter, multinational MR/CT registry and the relationship of prevalence with examination indications and patient characteristics. Materials and Methods This was a retrospective analysis of data from the European Society of Cardiovascular Radiology MR/CT Registry. Data from 208 506 cardiac CT examinations (median patient age, 66 years [IQR, 55-77]; 121 617 [58.33%] male patients) and 228 462 cardiac MRI examinations (median patient age, 57 years [IQR, 42-69]; 145 792 [63.81%] male patients) entered into the registry between January 2011 and November 2023 were analyzed. Clinically relevant extracardiac findings were defined as findings requiring follow-up examinations or influencing clinical management. The association of examination indication and patient characteristics, including age, with prevalence of extracardiac findings was evaluated using incidence rate ratios (IRRs) derived from multivariable Poisson regression models. Results The prevalence of clinically relevant extracardiac findings was 3.28% (6832 of 208 506) at cardiac CT and 1.50% (3421 of 228 462) at cardiac MRI examinations. Extracardiac findings were more common at CT examinations performed for transcatheter aortic valve replacement (IRR, 2.07; < .001) and structural heart disease (IRR, 1.44; < .001) compared with CT performed for coronary artery disease (IRR, 1; reference). Extracardiac findings were more common at MRI examinations performed for myocarditis (IRR, 1.36; < .001) and structural heart disease (IRR, 1.16; < .001) than for coronary artery disease. Older patient age was also significantly associated with higher prevalence of extracardiac findings, with an IRR for both CT and MRI examinations of 1.02 ( < .001). Conclusion Data from the multicenter, multinational MR/CT registry indicate that clinically relevant extracardiac findings are present at cardiovascular CT and MRI examinations, and the prevalence of these findings is associated with examination indication and patient age. Cardiac Imaging Techniques, Incidental Findings, MRI, CT Angiography, CT, Heart Disease © RSNA, 2024.

摘要

目的 从一个多中心、多国的磁共振/计算机断层扫描(MR/CT)注册中心确定心脏 CT 和 MRI 检查中临床相关的心脏外发现的发生率,并确定其与检查适应证和患者特征的关系。

材料与方法 这是对欧洲心血管放射学会 MR/CT 注册中心数据的回顾性分析。该研究纳入了 2011 年 1 月至 2023 年 11 月期间注册中心纳入的 208506 例心脏 CT 检查(患者中位年龄 66 岁[四分位距,5577 岁];121617 例[58.33%]为男性)和 228462 例心脏 MRI 检查(患者中位年龄 57 岁[四分位距,4269 岁];145792 例[63.81%]为男性)的数据。使用多变量泊松回归模型得出的发病率比值(IRR)评估了临床相关的心脏外发现与检查适应证和患者特征(包括年龄)的关系。

结果 心脏 CT 检查中临床相关的心脏外发现的发生率为 3.28%(6832 例/208506 例),心脏 MRI 检查中的发生率为 1.50%(3421 例/228462 例)。与心脏 CT 检查用于冠状动脉疾病(IRR,1;参考)相比,经导管主动脉瓣置换术(IRR,2.07; <.001)和结构性心脏病(IRR,1.44; <.001)的 CT 检查中,心脏外发现更为常见。与冠状动脉疾病相比,心肌炎(IRR,1.36; <.001)和结构性心脏病(IRR,1.16; <.001)的 MRI 检查中,心脏外发现更为常见。患者年龄较大与心脏外发现的发生率较高也显著相关,CT 和 MRI 检查的 IRR 均为 1.02( <.001)。

结论 多中心、多国的 MR/CT 注册中心的数据表明,心脏 CT 和 MRI 检查中存在临床相关的心脏外发现,这些发现的发生率与检查适应证和患者年龄有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ab6/11540291/e377d2f223f9/ryct.240117.VA.jpg

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