From the Departments of Radiology (D.B., M.M.F.P., H.H.H.A., S.A., L.G.M.C., H.I.Z., B.F.J.V., G.P.K., M.A.I., M.W.V.), Epidemiology (D.B., M.M.F.P., H.H.H.A., S.A., L.G.M.C., H.I.Z., Y.Y.H., B.F.J.V., V.J.A.V., J.G.J.V., A.P., A.H., A.v.d.L., M.A.I., M.W.V.), Neurology (S.A., P.J.K., M.A.I.), Neurosurgery (A.J.V.), and Internal Medicine (R.A.F.), Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands.
Radiology. 2016 Nov;281(2):507-515. doi: 10.1148/radiol.2016160218. Epub 2016 Jun 23.
Purpose To present an updated prevalence estimate for incidental findings on brain magnetic resonance (MR) images and provide information on clinical relevance, including natural course, over a period of up to 9 years. Materials and Methods This study was approved by the institutional review board and all participants gave informed consent. In a prospective population-based setting, structural brain MR imaging was performed in 5800 participants (mean age, 64.9 years; 3194 women [55.1%]). Trained reviewers recorded abnormalities, which were subsequently evaluated by neuroradiologists. The prevalence with 95% confidence interval (CI) of incidental findings was determined, and clinical management of findings that required the attention of a medical specialist was followed. Follow-up imaging in the study context provided information on the natural course of findings that were not referred. Results In 549 of 5800 participants (9.5% [95% CI: 8.7%, 10.3%]), incidental findings were found, of which meningiomas (143 of 5800; 2.5% [95% CI: 2.1%, 2.9%]) and cerebral aneurysms (134 of 5800; 2.3% [95% CI: 2.0%, 2.7%]) were most common. A total of 188 participants were referred to medical specialists for incidental findings (3.2% [95% CI: 2.8%, 3.7%]). Of these, 144 (76.6% [95% CI: 70.1%, 82.1%]) either underwent a wait-and-see policy or were discharged after the initial clinical visit. The majority of meningiomas and virtually all aneurysms not referred or referred but untreated remained stable in size during follow-up. Conclusion Incidental findings at brain MR imaging that necessitate further diagnostic evaluation occur in over 3% of the general middle-aged and elderly population, but are mostly without direct clinical consequences. RSNA, 2016.
提供脑磁共振成像（MR）偶然发现的最新患病率估计，并提供长达 9 年的临床相关性信息，包括自然病程。
本研究经机构审查委员会批准，所有参与者均签署知情同意书。在一项前瞻性的基于人群的研究中，对 5800 名参与者（平均年龄 64.9 岁，女性 3194 名[55.1%]）进行了结构性脑 MR 成像。经过培训的审查员记录了异常情况，随后由神经放射科医生进行评估。确定了偶然发现的患病率及其 95%置信区间（CI），并对需要医学专家关注的发现进行了临床处理。在研究背景下进行的随访成像提供了未转诊发现的自然病程信息。
在 5800 名参与者中，有 549 名（9.5%[95%CI：8.7%，10.3%]）发现了偶然发现，其中脑膜瘤（143/5800；2.5%[95%CI：2.1%，2.9%]）和脑动脉瘤（134/5800；2.3%[95%CI：2.0%，2.7%]）最为常见。共有 188 名参与者因偶然发现而被转介至医学专家（3.2%[95%CI：2.8%，3.7%]）。其中，144 名（76.6%[95%CI：70.1%，82.1%]）要么接受了观察等待策略，要么在初次就诊后出院。在随访过程中，大多数脑膜瘤和几乎所有未被转诊或被转诊但未治疗的动脉瘤在大小上保持稳定。
在一般中年和老年人群中，需要进一步诊断评估的脑 MR 成像偶然发现发生率超过 3%，但大多数情况下没有直接的临床后果。
