Hentschel F, Klix W-E
Abt. Neuroradiologie, Zentralinstitut für seelische Gesundheit, Fakultät für klinische Medizin Mannheim der Universität Heidelberg, 68159 Heidelberg.
Fortschr Neurol Psychiatr. 2006 Nov;74(11):651-5. doi: 10.1055/s-2006-932200.
Structural, quantitative and functional neuroimaging has contributed greatly to the advancement in clinical diagnosis and research into pathophysiology of psychiatric disorders. In diagnostic investigations, the frequency of "incidental" findings, i. e. potentially pathological findings, which are unexpected with regards to the primary diagnostic question and which cannot be related to the presenting clinical symptomatology, amounts up to 30 %. Approximately 2 - 5 % of these unexpected findings have immediate clinical consequences. The analysis of incidental findings in the context of clinical diagnostic procedures allows to extrapolate on their prevalence in experimental studies, because here, such findings are not systematically documented. Several medical, ethical and legal problems arise related to the detection, evaluation and documentation of incidental findings in clinical experimental studies. These problems and resulting obligations will be discussed and solutions with respect to the management of incident findings will be proposed.
结构、定量和功能神经影像学对精神疾病的临床诊断进展和病理生理学研究做出了巨大贡献。在诊断性检查中,“偶然”发现(即潜在的病理发现)的频率,也就是那些对于主要诊断问题而言出乎意料且与当前临床症状无关的发现,高达30%。这些意外发现中约有2 - 5%会产生直接的临床后果。在临床诊断程序中对偶然发现进行分析,有助于推断其在实验研究中的发生率,因为在实验研究中,此类发现并未得到系统记录。在临床实验研究中,与偶然发现的检测、评估和记录相关的几个医学、伦理和法律问题随之出现。将对这些问题及由此产生的义务进行讨论,并针对偶然发现的管理提出解决方案。