Burcu YAĞMUR, Hatice KEMAL
Anatolian Current Medical Journal - 2026;8(6):1229-1235
Aims: Incidental extracardiac findings (IECF) are regularly observed during routine cardiovascular magnetic resonance (CMR) examinations; nevertheless, their precise epidemiology and real-world clinical implications require further characterization. This study aimed to investigate the prevalence, regional distribution, and clinical significance of IECF using a structured reporting approach. Methods: A total of 597 consecutive patients undergoing CMR between 2021 and 2025 at a tertiary academic center were analyzed retrospectively. Patient demographics, primary CMR indications, and detected extracardiac lesions were documented. Utilizing a two-reader consensus, each IECF was categorized by anatomical site and risk-stratified into three distinct tiers: benign, potentially clinically significant, or clinically significant. Results: Extracardiac abnormalities were detected in 204 patients (34.2%). Categorization yielded 98 (16.4%) benign, 87 (14.6%) potentially significant, and 19 (3.2%) clinically significant findings. Overall, 106 patients (17.8%) met the combined actionable threshold (potentially or clinically significant), leading to downstream diagnostic or therapeutic evaluations in 61 cases (10.2% of the total cohort). The liver/biliary system (n=57, 9.5%) and lungs/pleura (n=42, 7%) represented the most frequent anatomical sites. Multivariable logistic regression revealed that advancing age (OR 1.29 per decade, 95% CI 1.13-1.48, p<0.001) and referral indications other than cardiomyopathy, myocarditis, or ischemia (OR 2.20, 95% CI 1.33-3.64, p=0.002) were independent predictors of actionable findings, whereas gender showed no association. Conclusion: Extracardiac lesions are prevalent in routine CMR practice, with approximately one in six patients harboring an actionable finding. Implementing systematic extracardiac evaluation alongside a tiered risk-stratification model enhances clinical utility and optimizes patient management.
