Hartwigsen Gesa, Siebner Hartwig R, Deuschl Günther, Jansen Olav, Ulmer Stephan
Department of Neurology, Christian-Albrechts-University, Kiel, Germany.
J Comput Assist Tomogr. 2010 Jul;34(4):596-600. doi: 10.1097/RCT.0b013e3181d9c2bb.
There is an ongoing debate about how to handle incidental findings (IF) detected in healthy individuals who participate in research-driven magnetic resonance imaging (MRI) studies. There are currently no established guidelines regarding their management.
We prospectively assessed the frequency of IF in 206 young healthy volunteers who additionally underwent structural MRIs of the whole brain as part of a scientific MRI protocol.
Assessment of the structural MRI by 2 board-certified neuroradiologists revealed IF in 19% of the subjects (n = 39). In approximately half of these subjects (n = 21), these findings were of potential clinical relevance (eg, arteriovenous malformations, cavernomas, pituitary abnormalities) and required further diagnostic investigations. None of these potentially relevant IF prompted immediate active medical treatment.
Incidental findings are very frequent in young healthy volunteers. Because many of the IF require further diagnostic workup, standardized procedures for MRI and the handling of these images are mandatory to ensure competent clinical management.
对于如何处理参与研究驱动的磁共振成像(MRI)研究的健康个体中检测到的偶然发现(IF),目前仍存在争议。目前尚无关于其管理的既定指南。
我们前瞻性评估了206名年轻健康志愿者中偶然发现的频率,这些志愿者作为一项科学MRI方案的一部分,还接受了全脑结构MRI检查。
两名获得委员会认证的神经放射科医生对结构MRI的评估显示,19%的受试者(n = 39)存在偶然发现。在这些受试者中,约一半(n = 21)的这些发现具有潜在临床相关性(例如动静脉畸形、海绵状血管瘤、垂体异常),需要进一步的诊断性检查。这些潜在相关的偶然发现均未促使立即进行积极的医学治疗。
偶然发现在年轻健康志愿者中非常常见。由于许多偶然发现需要进一步的诊断性检查,因此MRI的标准化程序以及这些图像的处理对于确保合理的临床管理是必不可少的。