The correlation of cardiovascular magnetic resonance imaging findings with clinical diagnoses and its acute impact on management changes in a regional Australian hospital

Cardiovascular magnetic resonance (CMR) is a noninvasive, detailed imaging modality regarded as the gold standard for assessing cardiac structure, function, and tissue characteristics. Data on its impact in acute settings, particularly in regional centers, remain limited. We evaluated the clinical impact of CMR on diagnostic accuracy and management decisions in acute cardiovascular presentations at a single regional Australian hospital. This retrospective, single-center study included 111 adult acute patients who underwent CMR in 2024. Pre- and post-CMR diagnoses and management plans were compared using Cohen kappa to assess agreement and quantify overall impact. CMR led to significant diagnostic reclassification, as supported by fair agreement between pre- and post-CMR diagnoses (κ = 0.305, P < .001). Management plans changed in 66.6% of cases, with fewer unnecessary treatments and altered procedural decisions; agreement was slight (κ = 0.079, P = .046). CMR significantly improved diagnostic precision and influenced downstream clinical management in acute cardiac settings.