MR imaging of the heart: Analysis of secondary findings in additional chest sequence

Introduction:

Cardiac MRI (CMRI) is a non-invasive and effective method for imaging of the heart. Aim of our study was to assess if an additional MR chest sequence (true-FISP) in the CMR examination setting has advantages in the detection of secondary findings versus the sequences tailored to imaging of the heart plus the survey.

Materials and Methods:

Imaging was performed with a Siemens Avanto 1,5 Tesla scanner and a Philips Intera 1,5 Tesla scanner. 400 patients were evaluated since April 2010at our institution. In addition to the standard long-axis and short-axis views an axial true-FISP sequence with a slice thickness of 6mm and 8mm was obtained covering the thorax from lung apex to diaphragm. The axial true-FISP images were evaluated for the presence of additional findings by an experienced radiologist. If additional pathologies were detected, the sequences tailored to the heart and the surveys were assessed for visibility of the finding.

The Results:

223 males and 177 females were reviewed. The mean age was 52 years with a range between 17 and 88 years. 25 secondary findings were diagnosed containing 16 pleural effusions with dystelectasis in some cases, a pulmonary fibrosis, a spondylodiscitis, ascites with liver cirrhosis, a lymphadenopathy at the hilum, a relapse of a mamma carcinoma with mass in the upper mediastinum, a lymphadenopathy of the mediastinum, a growth of adrenal glands metastases in a case of renal cancer and two times diaphragmatic elevation. 24 of the 25 secondary findings were diagnosed in accordance of the additional chest sequence. It was possible to diagnose all of the secondary findings in the sequences tailored to imaging of the heart plus the survey. The metastases of the adrenal glands were not pictured in the additional chest sequence. Thus pathology was delineated in the sequences tailored to the heart and the surveys.

Discussion:

In our study the additional chest sequence in the cardiac MR imaging setting didn't show a benefit in the detection of secondary findings. Actually with the sequences tailored to imaging of the heart plus the survey we were able to detect all of the 25 secondary findings. One pathologic finding was not visible in the additional chest sequence. Radiologists usually don't like “reading” survey images but in times of cost-effectiveness, time pressure and a challenging cardiac MR imaging patient collective with regard of advanced age and multimorbidity an additional chest sequence might not be necessary.