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一般成年人群体研究性全身 MRI 的潜在相关偶然发现:频率和处理方法。

Potentially relevant incidental findings on research whole-body MRI in the general adult population: frequencies and management.

机构信息

Department of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Str. 1, 17475 Greifswald, Germany.

出版信息

Eur Radiol. 2013 Mar;23(3):816-26. doi: 10.1007/s00330-012-2636-6. Epub 2012 Aug 22.

Abstract

OBJECTIVES

To report the frequencies of potentially relevant incidental findings in the general adult population and to develop a protocol for their management in whole-body magnetic resonance imaging (wb-MRI).

METHODS

A total of 2,500 adult subjects (1,271 women, 1,229 men; mean age 53 years) from the population-based Study of Health in Pomerania underwent standardised wb-MRI. Additionally, 1,129 participants received contrast-enhanced cardiac MRI, 619 men received MR angiography and 544 women received MR mammography. Two independent residents performed first-line reading. A third reader resolved disagreements. An interdisciplinary advisory board decided about disclosure.

RESULTS

There were 1,330 incidental findings of potential clinical relevance in 904 subjects (36.2 %). Nine findings (0.4 %) required immediate referral. In total, 1,052 findings (79.1 %) were confirmed by the advisory board and disclosed to 787 participants (31.5 %). The abdominal organs (6.8 %), the urinary tract (6.8 %) and the skeletal system (6.0 %) were affected most often. While 383 findings (36.4 %) were indicated as benign and 62 (5.9 %) as malignant, most abnormalities, 607 (57.7 %), were of an unclear nature.

CONCLUSIONS

Potentially relevant incidental findings are very common in wb-MRI research but the nature of these findings remains unclear in most cases. This requires dedicated management to protect subjects' welfare and research integrity.

摘要

目的

报告在普通成年人群中潜在相关偶然发现的频率,并制定全身磁共振成像(wb-MRI)中这些发现的管理方案。

方法

来自基于人群的波罗的海健康研究的 2500 名成年受试者(1271 名女性,1229 名男性;平均年龄 53 岁)接受了标准化的 wb-MRI。此外,1129 名参与者接受了对比增强心脏 MRI,619 名男性接受了磁共振血管造影,544 名女性接受了磁共振乳房摄影。两名独立的住院医师进行一线阅读。第三名读者解决了分歧。一个跨学科顾问委员会决定是否披露。

结果

904 名受试者中有 1330 名潜在临床相关的偶然发现(36.2%)。有 9 项发现(0.4%)需要立即转诊。共有 1052 项发现(79.1%)被顾问委员会证实,并向 787 名参与者(31.5%)披露。腹部器官(6.8%)、尿路(6.8%)和骨骼系统(6.0%)受影响最常见。虽然 383 项发现(36.4%)被认为是良性的,62 项(5.9%)被认为是恶性的,但大多数异常(607 项,57.7%)性质不明。

结论

在 wb-MRI 研究中,潜在相关的偶然发现非常常见,但在大多数情况下,这些发现的性质仍不清楚。这需要专门的管理来保护受试者的福利和研究的完整性。

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