The prevalence and clinical significance of incidental non-cardiac findings on cardiac magnetic resonance imaging and unreported rates of these findings in official radiology reports

Purpose
To evaluate the prevalence and significance of incidental non-cardiac findings (NCFs) on cardiac magnetic resonance imaging (MRI). We also aimed to assess the unreported rate and clinical significance of NCFs in official radiological reports.

Material and methods
Consecutive cardiac MRI examinations of 400 patients were retrospectively analysed and MR images reviewed by 2 observers blinded to official radiology reports. NCFs were classified as insignificant, significant, and major. In patients with significant and major findings, NCFs were classified as previously known or unknown, based on clinical archive. Moreover, we investigated the clinical follow-up results of patients with major NCF.

Results
Of 400 patients, 137 patients (34.3%) had a total of 175 NCFs. Fifty-nine NCFs were considered significant, and 23 were major. Patients with NCFs were significantly older than those without (p < 0.0001). Of 82 significant and major NCFs, 25 were previously unknown. In total, 18 significant and 4 major NCFs were unreported in official MRI reports. The unreported major NCFs were portal vein thrombosis, pulmonary nodule, pulmonary embolism, and liver nodule. The most common unreported findings were pulmonary artery-aorta dilatation and hiatal hernia. No statistical difference was found between official MRI reports and second consensus reading for the detection of major NCFs (p = 0.082).

Conclusions
The frequency of significant and major NCFs increases with age. Although no statistical difference was found between official MRI reports and second consensus reading for the detection of major NCFs, extra-cardiac findings should be carefully investigated during assessment.