Prevalence, clinical management, and natural course of incidental findings on brain MR images: The population-based Rotterdam scan study

Daniel Bos, Marielle M.F. Poels, Hieab H.H. Adams, Saloua Akoudad, Lotte G.M. Cremers, Hazel I. Zonneveld, Yoo Y. Hoogendam, Benjamin F.J. Verhaaren, Vincent J.A. Verlinden, Jasper G.J. Verbruggen, Abbas Peymani, Albert Hofman, Gabriel P. Krestin, Arnaud J. Vincent, Richard A. Feelders, Peter J. Koudstaal, Aad Van Der Lugt, M. Arfan Ikram, Meike W. Vernooij

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Resumen

Purpose: To present an updated prevalence estimate for incidental findings on brain magnetic resonance (MR) images and provide information on clinical relevance, including natural course, over a period of up to 9 years. Materials and Methods: This study was approved by the institutional review board and all participants gave informed consent. In a prospective population-based setting, structural brain MR imaging was performed in 5800 participants (mean age, 64.9 years; 3194 women [55.1%]). Trained reviewers recorded abnormalities, which were subsequently evaluated by neuroradiologists. The prevalence with 95% confidence interval (CI) of incidental findings was determined, and clinical management of findings that required the attention of a medical specialist was followed. Follow-up imaging in the study context provided information on the natural course of findings that were not referred. Results: In 549 of 5800 participants (9.5% [95% CI: 8.7%, 10.3%]), incidental findings were found, of which meningiomas (143 of 5800; 2.5% [95% CI: 2.1%, 2.9%]) and cerebral aneurysms (134 of 5800; 2.3% [95% CI: 2.0%, 2.7%]) were most common. A total of 188 participants were referred to medical specialists for incidental findings (3.2% [95% CI: 2.8%, 3.7%]). Of these, 144 (76.6% [95% CI: 70.1%, 82.1%]) either underwent a wait-andsee policy or were discharged after the initial clinical visit. The majority of meningiomas and virtually all aneurysms not referred or referred but untreated remained stable in size during follow-up. Conclusion: Incidental findings at brain MR imaging that necessitate further diagnostic evaluation occur in over 3% of the general middle-aged and elderly population, but are mostly without direct clinical consequences.

Idioma originalInglés
Páginas (desde-hasta)507-515
Número de páginas9
PublicaciónRadiology
Volumen281
N.º2
DOI
EstadoPublicada - 2016
Publicado de forma externa

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