Incidences and reporting rates of incidental findings on lumbar, thoracic, and cervical spinal magnetic resonance images and extra-neuronal findings on brain magnetic resonance imagesö

Year 2019, , 449 - 460, 04.05.2019

Volkan Kızılgöz , Hasan Aydın , Ali Kemal Sivrioğlu , Ümit Can Özcan Utku Menderes Sunay Sibel Karayol , Ahmet Erdem

https://doi.org/10.18621/eurj.379704

Cited By: 5

Abstract

Objective: This study aimed to evaluate the incidence rates,
reporting rates, and the best imaging plane and sequence for incidental
findings in patients undergoing spinal and brain magnetic resonance (MR)
imaging.

Methods: Three experienced radiologists retrospectively re-evaluated
the MR images of 1056 consecutive patients.

Results: The incidence rates for extraspinal incidental
findings for the images of the lumbar, thoracic, and cervical spine, and extra-neuronal
incidental findings on MR images of the brain were 35.47%, 32.25%, 29.16%, and
54.35%; respectively, with reporting rates of incidental findings for these
examinations of 31.47%, 8.33%, 29.50%, and 59.62%; respectively. For all
examination types, the T2-weighted sequence and the axial plain were the best
to reveal the incidental findings of MR examinations, other than that of the
cervical spine.

Conclusions: Incidental findings, which are commonly detected
during routine spinal and brain MR evaluations, are occasionally omitted from
formal radiological reports in daily practice. We strongly recommend checking
the T2-weighted axial plane for MR imaging of the lumbar, thoracic spine and
brain and taking a second look at the T2-weighted sagittal plane MR images of
the cervical spine during radiological evaluations. 

Keywords

Incidental findings, magnetic resonance imaging, spine, brain, report

References

• [1] Magnavita N, Magnavita G, Fileni A, Bergamaschi A. Ethical problems in radiology: medical error and disclosure. Radiol Med 2009;114:1345-55.
• [2] Fileni A, Magnavita N. A 12-year follow-up study of malpractice claims against radiologists in Italy. Radiol Med 2006;111:1009-22.
• [3] Frager DH, Elkin CM, Kansler F, Mendelsohn SL, Leeds NE. Extraspinal abnormalities identified on lumbar spine CT. Neuroradiology 1986;28:58-60.
• [4] Lee SY, Landis MS, Ross IG, Goela A, Leung AE. Extraspinal findings at lumbar spine CT examinations: prevalence and clinical importance. Radiology 2012;263:502-9.
• [5] Park HJ, Jeon YH, Rho MH, Lee EJ, Park NH, Park SI, et al. Incidental findings of the lumbar spine at MRI during herniated intervertebral disk disease evaluation. Am J Roentgenol 2011;196:1151-5.
• [6] Tuncel SA, Çağlı B, Tekataş A, Kırıcı MY, Ünlü E, Gençhellaç H. Extraspinal incidental findings on routine MRI of lumbar spine: prevalence and reporting rates in 1278 patients. Korean J Radiol 2015;16:866-73.
• [7] Kamath S, Jain N, Goyal N, Mansour R, Mukherjee K. Incidental findings on MRI of the spine. Clin Radiol 2009;64:353-61.
• [8] Grady AT, Sosa JA, Tanpitukpongse TP, Choudhury KR, Gupta RT, Hoang JK. Radiology reports for incidental thyroid nodules on CT and MRI: high variability across subspecialties. Am J Neuroradiol 2015;36:397-402.
• [9] Cho HW, Park JO, Lee YH, Chung SY, Suh JS. Should we recommend ultrasonography for an incidental thyroid nodule on additional cervicothoracic sagittal T2-weighted image of lumbar spine MRI? Investig Magn Reson Imaging 2015;19:224-30.
• [10] Mancuso AA. Another pesky incidental thyroid nodule! Am J Neuroradiol 2005;26:2444-5.
• [11] Katzman GI, Dagher AP, Patronas NJ. Incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers. JAMA 1999;282:36-9.
• [12] Vernooij MW, Ikram MA, Tanghe HL, Vincent AJPE, Hofman A, Krestin GP, et al. Incidental findings on brain MRI in the general population. New Engl J Med 2007;357:1821-8.
• [13] Morris Z, Whiteley WN, Longstreth WT Jr, Weber F, Lee YC, Tsushima Y, et al. Incidental findings on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ 2009;339:b3016.
• [14] Westbrook JI, Braithwaite J, McIntosh JH. The outcomes for patients with incidental lesions: serendipitous or iatrogenic? Am J Roentgenol 1998;171:1193-6.