Acibadem Maslak Hospital, Department of Radiology, Istanbul, Turkey.
Acibadem Mehmet Ali Aydinlar University, School of Medicine, Department of Radiology, Istanbul, Turkey.
Eur J Radiol. 2021 Apr;137:109584. doi: 10.1016/j.ejrad.2021.109584. Epub 2021 Feb 5.
To document the diagnostic yields of whole-body MRI (WB-MRI) screening for asymptomatic individuals by using a classification system that categorizes the findings by clinical relevance and provides a flowchart for further investigations, and to determine the influence of WB-MRI findings on clinical decision-making.
In this institutional review board-approved study, a retrospective review of individuals who underwent WB-MRI between 2009 and 2020 was conducted, and asymptomatic participants who underwent non-contrast-enhanced comprehensive WB-MRI for screening were enrolled. Participants were classified into four categories based on WB-MRI findings, and those with relevant findings (i.e., categories 3 and 4) were referred for further diagnostic workup. The participants' medical records were investigated, and interviews were conducted to reveal false-negative findings and identify the number of WB-MRI-triggered treatments.
We included 576 participants (377 [65.4 %] men, 199 [34.6 %] women; mean age, 48.40 ± 10.82 years), of which 266 (46.2 %) and 310 (53.8 %) underwent WB-MRI with 1.5 T and 3.0 T magnets, respectively. Approximately one-third of the participants showed clinically relevant findings, and 65 (11.2 %) received a treatment triggered by WB-MRI. Notably, 15 (2.6 %) and 28 (4.8 %) participants had cancers and intracranial aneurysms, respectively. Of the 576 participants, 16 (2.8 %) had false-negative findings, among which five had cancers.
WB-MRI yields numerous important findings that trigger therapeutic interventions in a large sample of asymptomatic adults. However, considering its inherent limitations, WB-MRI might be inadequate for detecting malignancies such as colon, thyroid, and breast cancers; thus, it may serve as a complementary screening method for health-conscious individuals.
使用一种分类系统记录全身 MRI（WB-MRI）筛查无症状个体的诊断结果，该系统根据临床相关性对发现进行分类，并提供进一步检查的流程图，并确定 WB-MRI 结果对临床决策的影响。
在这项经机构审查委员会批准的研究中，对 2009 年至 2020 年间进行 WB-MRI 的个体进行了回顾性审查，并招募了进行非增强性综合 WB-MRI 筛查的无症状参与者。根据 WB-MRI 结果将参与者分为四类，有相关发现的参与者（即第 3 类和第 4 类）被转介进行进一步的诊断检查。调查了参与者的病历，并进行了访谈以揭示假阴性结果并确定 WB-MRI 触发的治疗数量。
我们纳入了 576 名参与者（377 名男性[65.4%]，199 名女性[34.6%]；平均年龄 48.40±10.82 岁），其中 266 名（46.2%）和 310 名（53.8%）分别接受了 1.5 T 和 3.0 T 磁体的 WB-MRI。约三分之一的参与者有临床相关发现，65 名（11.2%）接受了 WB-MRI 触发的治疗。值得注意的是，15 名（2.6%）和 28 名（4.8%）参与者分别患有癌症和颅内动脉瘤。在 576 名参与者中，有 16 名（2.8%）有假阴性结果，其中 5 名患有癌症。
WB-MRI 在大量无症状成年人中产生了许多重要的发现，这些发现触发了治疗干预。然而，考虑到其固有的局限性，WB-MRI 可能不足以检测结肠癌、甲状腺癌和乳腺癌等恶性肿瘤；因此，它可能是有健康意识的个体的一种补充筛查方法。
