Intracranial incidental findings on brain MR images in a pediatric neurology practice: A retrospective study
Received 4 May 2007; received in revised form 17 June 2007; accepted 28 June 2007.
Abstract
Background and purpose
Previous studies have addressed the prevalence of incidental findings largely in healthy adult and pediatric populations. Our study aims to elucidate the prevalence of incidental findings in a pediatric neurology practice.
Methods
We reviewed the charts of 1618 patients seen at a pediatric neurology practice at a tertiary care center from September 2003 to December 2005 for clinical data and incidental intracranial findings on brain magnetic resonance imaging reports. Incidental findings were divided into two categories: normal or abnormal variants. Clinical and demographic data were assessed for associations with incidental findings.
Results
From 1618 charts reviewed, only 666 patients (41% of all patients) had brain MRIs ordered. One-hundred and seventy-one (171) patients (25.7% of all patients; 95% CI: 22.6, 29.0) had incidental findings. Of these, 113 (17.0%; 95% CI: 14.1, 19.8) were classified as normal-variants and 58 (8.7%; 95% CI: 6.6, 10.9) were classified as abnormal. The nature of incidental findings was not related to age group, sex or clinical diagnosis (p=0.29, p=0.31 and p=0.69 respectively). Two patients (0.3%; 95% CI: ∼0.0, 0.7) required neurosurgical referral.
Conclusions
We report a high prevalence of and a low rate of referrals for incidental findings in comparison to previous studies. The present study may help guide management decisions and discussions with patients and families. Future studies should attempt to address issues of associations between primary or secondary diagnoses and intracranial incidental findings in a controlled, prospective fashion.
aSection of Child Neurology,Department of Pediatrics, Temple University School of Medicine, Philadelphia, Pennsylvania, USA
bSection of General Pediatrics, Department of Pediatrics, Temple University School of Medicine, Philadelphia, Pennsylvania, USA
Corresponding author. Temple University Children's Medical Center, 3509 North Broad Street, Philadelphia, PA 19140, USA. Tel.: +1 215 707 6639; fax: +1 215 707 6629.
ABSTRACT