To determine the prevalence of non-cardiac findings in patients referred to cardiac MR imaging in clinical routine.

From April 2002 to December 2003, 1359 patients underwent cardiac MRI on a 1.5T MR system for detection of myocardial ischemia n=638, assessment of myocardial viability n=479, assessment of cardiac masses or thrombi n=139 and assessment of myocarditis or cardiomyopathies n=103. The standard imaging protocol included a proton-density weighted dark-blood prepared half-Fourier single-shot turbo spin-echo (HASTE, TR 2RR, TE 23 ms, FA 160°) sequence in axial orientation covering the entire chest in a single breath-hold, steady-state free precession cine sequences (TR 3 ms, TE 1.5 ms, FA 60°) in standard long and short axes orientations and inversion recovery gradient echo sequences (TR 8 ms, TE 4 ms, TI 180-160 ms, FA 20°) in the same orientation. All relevant non-cardiac findings unknown prior to MR imaging were recorded.

A total of 124 relevant clinical findings were detected in 118 patients. 49 thoracic pathologies were recorded including pulmonary lesions suspected for bronchial carcinoma or metastases n=23, hilar masses n=9, enlarged mediastinal lymph nodes n=12 and mediastinal masses n=5. Additionally, 47 vascular variants or pathologies (dilation or aneurysm of the thoracic aorta n=37, right aortic arch n=1, aberrant right subclavian artery n=4, pulmonary emboli n=3, persistent left superior vena cava n=1, vena cava thrombus n=1) were detected. 28 relevant findings were located in the upper abdomen including non-cystic liver lesions n=25, renal cell carcinoma n=1, hydronephrosis n=1 and spinal metastases n=1. 78 patients were referred to additional diagnostic procedures wich confirmed the MR findings in 85% of the cases, whereas 46 patients were referred for follow-up examinations.

Accidental non-cardiac findings can frequently be detected during cardiac MR examinations using standard imaging protocols. Therefore investigators reporting cardiac MR studies have to focus on all visualized organs and should be trained in cross-sectional anatomy and the MR appearance of non-cardiac diseases.