Brain Research Imaging Centre, Division of Clinical Neurosciences, University of Edinburgh, Edinburgh, United Kingdom.
PLoS One. 2013 Aug 15;8(8):e71467. doi: 10.1371/journal.pone.0071467. eCollection 2013.
Incidental findings in neuroimaging occur in 3% of volunteers. Most data come from young subjects. Data on their occurrence in older subjects and their medical, lifestyle and financial consequences are lacking. We determined the prevalence and medical consequences of incidental findings found in community-dwelling older subjects on brain magnetic resonance imaging.
Prospective cohort observational study.
Single centre study with input from secondary care.
Lothian Birth Cohort 1936, a study of cognitive ageing.
Incidental findings identified by two consultant neuroradiologists on structural brain magnetic resonance imaging at age 73 years; resulting medical referrals and interventions.
PREVALENCE OF INCIDENTAL FINDINGS BY INDIVIDUAL CATEGORIES: neoplasms, cysts, vascular lesions, developmental, ear, nose or throat anomalies, by intra- and extracranial location; visual rating of white matter hyperintensities and brain atrophy.
There were 281 incidental findings in 223 (32%) of 700 subjects, including 14 intra- or extracranial neoplasms (2%), 15 intracranial vascular anomalies (2%), and 137 infarcts or haemorrhages (20%). Additionally, 153 had moderate/severe deep white matter hyperintensities (22%) and 176 had cerebral atrophy at, or above, the upper limit of normal (25%) compared with a normative population template. The incidental findings were unrelated to white matter hyperintensities or atrophy; about a third of subjects had both incidental findings and moderate or severe WMH and a quarter had incidental findings and atrophy. The incidental findings resulted in one urgent and nine non-urgent referrals for further medical assessment, but ultimately in no new treatments.
In community-dwelling older subjects, incidental findings, including white matter hyperintensities and atrophy, were common. However, many findings were not of medical importance and, in this age group, most did not result in further assessment and none in change of treatment.
神经影像学中的偶然发现发生率为 3%，大多数数据来自年轻人群。目前缺乏关于老年人群中偶然发现的发生率及其医疗、生活方式和经济后果的数据。我们旨在确定在社区居住的老年人群中，脑部磁共振成像偶然发现的发生率及其医疗后果。
前瞻性队列观察性研究。
单中心研究，二级医疗机构参与。
洛锡安出生队列 1936，一项认知衰老研究。
两位顾问神经放射科医生在 73 岁时对结构性脑部磁共振成像进行评估，确定偶然发现；随后的医疗转介和干预。
偶然发现的发生率，按个体类别分类：肿瘤、囊肿、血管病变、发育异常、耳、鼻或喉异常，按颅内和颅外位置；脑白质高信号和脑萎缩的视觉评分。
在 700 名受试者中的 223 名（32%）中发现 281 个偶然发现，包括 14 个颅内或颅外肿瘤（2%）、15 个颅内血管异常（2%）和 137 个梗死或出血（20%）。此外，153 名受试者有中度/重度深部脑白质高信号（22%），176 名受试者脑萎缩达到或超过正常上限（25%），与正常人群模板相比。偶然发现与脑白质高信号或萎缩无关；大约三分之一的受试者既有偶然发现又有中度或重度脑白质高信号，四分之一的受试者既有偶然发现又有脑萎缩。偶然发现导致 1 例紧急和 9 例非紧急转介进一步评估，但最终没有新的治疗方法。
在社区居住的老年人群中，偶然发现包括脑白质高信号和萎缩，较为常见。然而，许多发现并不具有医学重要性，在这个年龄段，大多数偶然发现没有导致进一步的评估，也没有改变治疗方法。
