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磁共振成像偶然发现颅内异常的发生率：系统评价和荟萃分析。

Prevalence of incidental intracranial findings on magnetic resonance imaging: a systematic review and meta-analysis.

机构信息

National Neurosurgical Centre, Beaumont Hospital, Dublin 9, Ireland.

School of Medicine, University College Dublin, Dublin, Ireland.

出版信息

Acta Neurochir (Wien). 2022 Oct;164(10):2751-2765. doi: 10.1007/s00701-022-05225-7. Epub 2022 May 8.

DOI:10.1007/s00701-022-05225-7
PMID:35525892
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9519720/
Abstract

BACKGROUND

As the volume and fidelity of magnetic resonance imaging (MRI) of the brain increase, observation of incidental findings may also increase. We performed a systematic review and meta-analysis to determine the prevalence of various incidental findings.

METHODS

PubMed/MEDLINE, EMBASE and SCOPUS were searched from inception to May 24, 2021. We identified 6536 citations and included 35 reports of 34 studies, comprising 40,777 participants. A meta-analysis of proportions was performed, and age-stratified estimates for each finding were derived from age-adjusted non-linear models.

RESULTS

Vascular abnormalities were observed in 423/35,706 participants (9.1/1000 scans, 95%CI 5.2-14.2), ranging from 2/1000 scans (95%CI 0-7) in 1-year-olds to 16/1000 scans (95%CI 1-43) in 80-year-olds. Of these, 204/34,306 were aneurysms (3.1/1000 scans, 95%CI 1-6.3), which ranged from 0/1000 scans (95%CI 0-5) at 1 year of age to 6/1000 scans (95%CI 3-9) at 60 years. Neoplastic abnormalities were observed in 456/39,040 participants (11.9/1000 scans, 95%CI 7.5-17.2), ranging from 0.2/1000 scans (95%CI 0-10) in 1-year-olds to 34/1000 scans (95%CI 12-66) in 80-year-olds. Meningiomas were the most common, in 246/38,076 participants (5.3/1000 scans, 95%CI 2.3-9.5), ranging from 0/1000 scans (95%CI 0-2) in 1-year-olds to 17/1000 scans (95%CI 4-37) in 80-year-olds. Chiari malformations were observed in 109/27,408 participants (3.7/1000 scans, 95%CI 1.8-6.3), pineal cysts in 1176/32,170 (9/1000 scans, 95%CI 1.8-21.4) and arachnoid cysts in 414/36,367 (8.5/1000 scans, 95%CI 5.8-11.8).

CONCLUSION

Incidental findings are common on brain MRI and may result in substantial resource expenditure and patient anxiety but are often of little clinical significance.

摘要

背景

随着磁共振成像（MRI）脑容积和保真度的增加，偶然发现的观察结果也可能增加。我们进行了一项系统评价和荟萃分析，以确定各种偶然发现的发生率。

方法

从成立到 2021 年 5 月 24 日，我们在 PubMed/MEDLINE、EMBASE 和 SCOPUS 上进行了搜索。我们确定了 6536 条引用，并纳入了 35 项研究的 35 项报告，包括 40777 名参与者。对比例进行了荟萃分析，并从年龄调整的非线性模型中得出了每个发现的年龄分层估计值。

结果

在 35706 名参与者（423/35706，95%CI 5.2-14.2）中观察到血管异常，范围从 1 岁儿童的 2/1000 扫描（95%CI 0-7）到 80 岁儿童的 16/1000 扫描（95%CI 1-43）。其中，204/34306 为动脉瘤（3.1/1000 扫描，95%CI 1-6.3），范围从 1 岁儿童的 0/1000 扫描（95%CI 0-5）到 60 岁儿童的 6/1000 扫描（95%CI 3-9）。在 39040 名参与者（456/39040，11.9/1000 扫描，95%CI 7.5-17.2）中观察到肿瘤异常，范围从 1 岁儿童的 0.2/1000 扫描（95%CI 0-10）到 80 岁儿童的 34/1000 扫描（95%CI 12-66）。脑膜瘤最常见，在 38076 名参与者中（246/38076，5.3/1000 扫描，95%CI 2.3-9.5），范围从 1 岁儿童的 0/1000 扫描（95%CI 0-2）到 80 岁儿童的 17/1000 扫描（95%CI 4-37）。在 27408 名参与者中（109/27408，3.7/1000 扫描，95%CI 1.8-6.3）中观察到 Chiari 畸形，在 32170 名参与者中（1176/32170，9/1000 扫描，95%CI 1.8-21.4）中观察到松果体囊肿，在 36367 名参与者中（414/36367，8.5/1000 扫描，95%CI 5.8-11.8）中观察到蛛网膜囊肿。

结论

偶然发现很常见，可能导致大量资源支出和患者焦虑，但通常无临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c295/9519720/848c821df90a/701_2022_5225_Fig7_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c295/9519720/848c821df90a/701_2022_5225_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c295/9519720/7de0b21564ce/701_2022_5225_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c295/9519720/a2e39a7a4ef5/701_2022_5225_Fig3_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c295/9519720/848c821df90a/701_2022_5225_Fig7_HTML.jpg

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