Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany; Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-University Munich, Munich, Germany.
Eur J Radiol. 2021 Jan;134:109451. doi: 10.1016/j.ejrad.2020.109451. Epub 2020 Nov 28.
Management of incidental findings (IF) remains controversial but highly relevant. Our aim was to assess the frequency, management and psychosocial consequences of IF reporting in a population-based cohort study undergoing whole-body MR imaging.
The study was nested in a prospective cohort from a longitudinal, population-based cohort (KORA-FF4) in southern Germany. All MR obtained on 3 T MR scanner were reviewed by board-certified radiologists regarding clinically relevant IF. A baseline and follow-up questionnaires including PHQ-9 were completed prior to and 6-month after to the scan.
Of 400 participants (56.3 ± 9.2years, 58 % male) undergoing whole-body MR, IF were found in 22 % of participants (n = 89); most frequently located in the abdominal sequences. In the pre-scan survey, most participants stated as the motivation that they wanted to "contribute to a scientific purpose" (91 %), while "knowing whether I'm healthy" was the most frequent motivation reported 6 months post-scan (88 %). The desire for IF reporting increased over time (pre- vs. 6-months-post-scan), also for clinically less important IF (72 % vs. 84 %, p = 0.001). Regarding psychosocial impact, a small portion (3.4 %) reported that awaiting the IF report added "definitely" or "very probably" additional stress burden. Of participants with reported IF, 56.8 % classified the results as "very helpful". In the post-scan survey moderate depression was observed in 3.3 % and severe depression in 1.2 %. This did not differ between participants with and without reported IF.
In a cohort with whole-body MR imaging, the prevalence of IF was high. Participants considered reporting of IF highly important and added only minor psychological burden.
偶然发现（IF）的管理仍然存在争议，但非常重要。我们的目的是评估在接受全身磁共振成像的基于人群的队列研究中，IF 报告的频率、管理和心理社会后果。
该研究嵌套在德国南部一项前瞻性队列研究（KORA-FF4）中。所有在 3T 磁共振扫描仪上获得的磁共振图像均由经过委员会认证的放射科医生进行审查，以确定是否存在与临床相关的 IF。在扫描前和扫描后 6 个月完成基线和随访问卷，包括 PHQ-9。
在接受全身磁共振成像的 400 名参与者（56.3±9.2 岁，58%为男性）中，22%的参与者（n=89）发现了 IF；最常见的位置在腹部序列。在扫描前的调查中，大多数参与者表示他们的动机是“为科学目的做出贡献”（91%），而“了解自己是否健康”是扫描后 6 个月报告中最常见的动机（88%）。对 IF 报告的渴望随着时间的推移而增加（扫描前与扫描后 6 个月），对于临床意义较小的 IF 也是如此（72%比 84%，p=0.001）。关于心理社会影响，一小部分（3.4%）报告称，等待 IF 报告增加了“肯定”或“非常可能”的额外压力负担。在报告 IF 的参与者中，56.8%将结果评为“非常有帮助”。在扫描后调查中，有 3.3%的参与者中度抑郁，1.2%的参与者重度抑郁。这在有和没有报告 IF 的参与者之间没有差异。
在接受全身磁共振成像的队列中，IF 的发生率很高。参与者认为 IF 的报告非常重要，只增加了轻微的心理负担。
