Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA.
Department of Radiology, Washington Permanente Medical Group, Seattle, WA, USA.
Br J Radiol. 2023 Feb;96(1142):20220108. doi: 10.1259/bjr.20220108. Epub 2022 May 10.
Utilization of brain MRI has dramatically increased in recent decades due to rapid advancement in imaging technology and improving accessibility. As a result, radiologists increasingly encounter findings incidentally discovered on brain MRIs which are performed for unrelated indications. Some of these findings are clinically significant, necessitating further investigation or treatment and resulting in increased costs to healthcare systems as well as increased patient anxiety. Moreover, management of these incidental findings poses a significant challenge for referring physicians. Therefore, it is important for interpreting radiologists to know the prevalence, clinical consequences, and appropriate management of these findings. There is a wide spectrum of incidental findings on brain MRI such as asymptomatic brain infarct, age-related white matter changes, microhemorrhages, intracranial tumors, intracranial cystic lesions, and anatomic variants. This article provides a narrative review of important incidental findings encountered on brain MRI in adults with a focus on prevalence, clinical implications, and recommendations on management of these findings based on current available data.
由于成像技术的快速进步和可及性的提高，近几十年来脑 MRI 的应用显著增加。因此，放射科医生越来越多地遇到在为其他原因进行的脑 MRI 上偶然发现的结果。其中一些发现具有临床意义，需要进一步调查或治疗，这会增加医疗系统的成本，并增加患者的焦虑。此外，这些偶然发现的处理对转诊医生来说也是一个重大挑战。因此，对于解释放射科医生来说，了解这些发现的普遍性、临床后果和适当的管理方法非常重要。脑 MRI 上有广泛的偶然发现，如无症状性脑梗死、与年龄相关的白质改变、微出血、颅内肿瘤、颅内囊性病变和解剖变异。本文对成人脑 MRI 上的重要偶然发现进行了叙述性综述，重点介绍了这些发现的流行率、临床意义以及根据现有数据对这些发现的管理建议。
