VOLKAN KIZILGÖZ, HASAN AYDIN, Ali Kemal SİVRİOĞLU, Ümit Can ÖZCAN, Utku MENDERES, SUNAY SİBEL KARAYOL, AHMET ERDEM

Incidences and reporting rates of incidental findings on lumbar, thoracic, and cervical spinal magnetic resonance images and extra-neuronal findings on brain magnetic resonance images

Objective: This study aimed to evaluate the incidence rates, reporting rates, and the best imaging plane andsequence for incidental findings in patients undergoing spinal and brain magnetic resonance (MR) imaging.Methods: Three experienced radiologists retrospectively re-evaluated the MR images of 1056 consecutivepatients.Results: The incidence rates for extraspinal incidental findings for the images of the lumbar, thoracic, andcervical spine, and extra-neuronal incidental findings on MR images of the brain were 35.47%, 32.25%,29.16%, and 54.35%; respectively, with reporting rates of incidental findings for these examinations of 31.47%,8.33%, 29.50%, and 59.62%; respectively. For all examination types, the T2-weighted sequence and the axialplain were the best to reveal the incidental findings of MR examinations, other than that of the cervical spine.Conclusions: Incidental findings, which are commonly detected during routine spinal and brain MRevaluations, are occasionally omitted from formal radiological reports in daily practice. We strongly recommendchecking the T2-weighted axial plane for MR imaging of the lumbar, thoracic spine and brain and taking asecond look at the T2-weighted sagittal plane MR images of the cervical spine during radiological evaluations.

PDF

___

[1] Magnavita N, Magnavita G, Fileni A, Bergamaschi A. Ethical problems in radiology: medical error and disclosure. Radiol Med 2009;114:1345-55.

[2] Fileni A, Magnavita N. A 12-year follow-up study of malpractice claims against radiologists in Italy. Radiol Med 2006;111:1009-22.

[3] Frager DH, Elkin CM, Kansler F, Mendelsohn SL, Leeds NE. Extraspinal abnormalities identified on lumbar spine CT. Neuroradiology 1986;28:58-60.

[4] Lee SY, Landis MS, Ross IG, Goela A, Leung AE. Extraspinal findings at lumbar spine CT examinations: prevalence and clinical importance. Radiology 2012;263:502-9.

[5] Park HJ, Jeon YH, Rho MH, Lee EJ, Park NH, Park SI, et al. Incidental findings of the lumbar spine at MRI during herniated intervertebral disk disease evaluation. Am J Roentgenol 2011;196:1151-5.

[6] Tuncel SA, Çağlı B, Tekataş A, Kırıcı MY, Ünlü E, Gençhellaç H. Extraspinal incidental findings on routine MRI of lumbar spine: prevalence and reporting rates in 1278 patients. Korean J Radiol 2015;16:866-73.

[7] Kamath S, Jain N, Goyal N, Mansour R, Mukherjee K. Incidental findings on MRI of the spine. Clin Radiol 2009;64:353-61.

[8] Grady AT, Sosa JA, Tanpitukpongse TP, Choudhury KR, Gupta RT, Hoang JK. Radiology reports for incidental thyroid nodules on CT and MRI: high variability across subspecialties. Am J Neuroradiol 2015;36:397-402.

[9] Cho HW, Park JO, Lee YH, Chung SY, Suh JS. Should we recommend ultrasonography for an incidental thyroid nodule on additional cervicothoracic sagittal T2-weighted image of lumbar spine MRI? Investig Magn Reson Imaging 2015;19:224-30.

[10] Mancuso AA. Another pesky incidental thyroid nodule! Am J Neuroradiol 2005;26:2444-5.

[11] Katzman GI, Dagher AP, Patronas NJ. Incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers. JAMA 1999;282:36-9.

[12] Vernooij MW, Ikram MA, Tanghe HL, Vincent AJPE, Hofman A, Krestin GP, et al. Incidental findings on brain MRI in the general population. New Engl J Med 2007;357:1821-8.

[13] Morris Z, Whiteley WN, Longstreth WT Jr, Weber F, Lee YC, Tsushima Y, et al. Incidental findings on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ 2009;339:b3016.

[14] Westbrook JI, Braithwaite J, McIntosh JH. The outcomes for patients with incidental lesions: serendipitous or iatrogenic? Am J Roentgenol 1998;171:1193-6.