Tomography (May 2021)
Incidence and Outcome of Unexpected Non-Cardiac Abnormality on Cardiac Magnetic Resonance Imaging: A Report from Northeastern Thailand
Abstract
Objective: To ascertain non-cardiac abnormality (NCA) incidence in patients undergoing clinical cardiovascular magnetic resonance imaging (CMR) and determine such patients’ clinical importance. Methods: Consecutive patients undertaking CMR study from January 2012 to June 2017 for various cardiovascular diseases were enrolled. To assess NCA’s therapeutic importance, all incidental findings that were not expected from the patient’s history were analyzed. A careful review of medical history determines the information on mortality. Results: Three hundred and eighty-two consecutive patients (mean age 58 ± 11 years) who underwent CMR for different clinical indications were enrolled in the present study. Potentially significant results have been identified as abnormalities that require further clinical or radiological follow-up or therapy. On CMR, 118 NCA (30.9%) were found. In 25 patients, potential clinically significant NCAs, such as aortic aneurysm (n = 3), aortic dissection (n = 2), pulmonary thromboembolism (n = 2), and malignancy (n = 18), were identified (6.54%). In terms of one-year mortality data, in a patient without NCA, we observed a significantly higher survival rate than those with NCA (p = 0.0085) and a higher mortality rate in a patient with clinically significant NCA than a patient with irrelevant NCA (p = 0.02). Survival, as assessed via Kaplan‒Meier analysis, disclosed significantly higher mortality in the patients with clinically significant NCA than patients with irrelevant NCA (HR = 11.20, CI = 4.71–26.60, p Conclusions: We concluded that it is vital for the CMR study to determine the relevance of NCA, especially in the cholangiocarcinoma endemic region such as northeastern Thailand. Eventually, to reorganize the patients according to appropriate management, clinical correlation and prognosis must be summarily established.
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