Extra-cardiac findings in cardiovascular magnetic resonance: What the imaging cardiologist needs to know

Cardiovascular magnetic resonance (cmr) is an established non-invasive technique to comprehensively assess cardiovascular structure and function in a variety of acquired and inherited cardiac conditions. a significant amount of the neck,thorax and upper abdomen are imaged at the time of routine clinical cmr,particularly in the initial multi-slice axial and coronal images. the discovery of unsuspected disease at the time of imaging has ethical,financial and medico-legal implications. extra-cardiac findings at the time of cmr are common,can be important and can change clinical management. certain patient groups undergoing cmr are at particular risk of important extra-cardiac findings as several of the cardiovascular risk factors for atherosclerosis are also risk factors for malignancy. furthermore,the presence of certain extra-cardiac findings may contribute to the interpretation of the primary cardiac pathology as some cardiac conditions have multi-systemic extra-cardiac involvement. the aim of this review is to give an overview of the type of extra-cardiac findings that may become apparent on cmr,subdivided by anatomical location. we focus on normal variant anatomy that may mimic disease,common incidental extra-cardiac findings and important imaging signs that help distinguish sinister pathology from benign disease. we also aim to provide a framework to the approach and potential further diagnostic work-up of incidental extra-cardiac findings discovered at the time of cmr. however,it is beyond the scope of this review to discuss and determine the clinical significance of extracardiac findings at cmr. © 2016 rodrigues et al.