Incidental Findings in Youths Volunteering for Brain MRI Research

Gur, Raquel E.; Kaltman, D.; Melhem, Elias R.; Ruparel, Kosha; Prabhakaran, Karthik; Riley, M.; Yodh, E.; Hákonarson, Hákon; Satterthwaite, Theodore D.; Gur, Ruben C.

doi:10.3174/ajnr.a3525

Cited by 71 publications

(82 citation statements)

References 15 publications

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“…Since HUNT MRI was a quite healthy cohort [8] and all findings were checked against patient records and patient medical history, it seems unlikely that the prevalence of incidental findings was overestimated in the study. Nevertheless, the number of incidental findings on brain MRI was higher in this study than in most published studies, particularly the earlier studies [1][2][3][4][5][9][10][11][12][13][14][15][16].…”

Section: Reviewcontrasting

confidence: 53%

Incidental Findings on Brain MRI: Insight from HUNT MRI - A General Population Study

Ak¹

2016

J Headache Pain Manag

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The aim of the study was to assess the prevalence of incidental findings on brain Magnetic Resonance Imaging (MRI) in a general population of middle aged adults. In addition, the clinical impact, follow up and postoperative outcome resulting from uncovering an incidental finding during a research study were examined.Brain MRI was performed in a general population as part of the Nord-Trøndelag Health Study (HUNT), which is a multiphase, multipurpose health study on the inhabitant's ≥13 years in the county of Nord-Trøndelag, Norway. Only standard MRI exclusion criteria were applied to participant selection. In total, 1006 HUNT participants (530 women) between 50 and 66 years were included.The cohort was representative for the population, but participant versus nonparticipant assessment demonstrated a somewhat better health profile of those included in HUNT MRI. Scanning was performed on one 1.5T scanner with a comprehensive scan protocol, all scans were read by two senior neuroradiologists and presence of intracranial findings were evaluated based on patient hospital records and medical history obtained by phone interview.The prevalence of incidental findings on brain MRI was 29% and 15% of the relatively healthy, middle aged adults participating in HUNT MRI were referred to some type of follow-up. Acquired and developmental cerebrovascular pathologies (silent infarctions, excessive white matter hyperintensities relative to age, aneurysms, occlusion/stenosis of arteries, arteriovenous malformation, and cavernous hemangioma) were most common, followed by extra-and intra-axial brain tumors (meningioma, pituitary tumors, glioma or vestibular schwannoma). Intracranial intervention was performed 1.4% of the cohort with one postoperative deficit, giving a prevalence of 0.1% for a postoperative neurological deficit as a result of brain MRI in a research setting.Based on the HUNT MRI cohort, about 1 in 7 middle aged participants from the general population will require clinical follow up if undergoing brain MRI scanning in a research setting. Unrecognized excessive white matter hyperintensities and silent strokes were frequent findings, and demonstrate a significant potential for different types of measures aimed at preventing and/or ameliorating unidentified arteriosclerotic disease to maintain brain health in even quite healthy middle aged adults.

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Section: Reviewcontrasting

confidence: 53%

Incidental Findings on Brain MRI: Insight from HUNT MRI - A General Population Study

Ak¹

2016

J Headache Pain Manag

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“…The overall prevalence of CSP in the population varies greatly in the literature, depending on the cohort and technique used. 18,19 Moreover, a higher prevalence of CSP has been linked to neurodevelopmental diseases such as schizophrenia [20][21][22][23] as well as to genetic conditions. 24 Increased rates of CSP have also been reported among boxers and participants of other contact-sports exposed to repetitive head impacts.…”

Section: Introductionmentioning

confidence: 99%

Cavum Septi Pellucidi in Symptomatic Former Professional Football Players

Koerte

Hufschmidt

Muehlmann

et al. 2016

Journal of Neurotrauma

113

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Post-mortem studies reveal a high rate of cavum septi pellucidi (CSP) in chronic traumatic encephalopathy (CTE). It remains, however, to be determined whether or not the presence of CSP may be a potential in vivo imaging marker in populations at high risk to develop CTE. The aim of this study was to evaluate CSP in former professional American football players presenting with cognitive and behavioral symptoms compared with noncontact sports athletes. Seventytwo symptomatic former professional football players (mean age 54.53 years, standard deviation [SD] 7.97) as well as 14 former professional noncontact sports athletes (mean age 57.14 years, SD 7.35) underwent high-resolution structural 3T magnetic resonance imaging. Two raters independently evaluated the CSP, and interrater reliability was calculated. Within National Football League players, an association of CSP measures with cognitive and behavioral functioning was evaluated using a multivariate mixed effects model. The measurements of the two raters were highly correlated (CSP length: rho = 0.98; Intraclass Correlation Coefficient [ICC] 0.99; p < 0.0001; septum length: rho = 0.93; ICC 0.96; p < 0.0001). For presence versus absence of CSP, there was high agreement (Cohen kappa = 0.83, p < 0.0001). A higher rate of CSP, a greater length of CSP, as well as a greater ratio of CSP length to septum length was found in symptomatic former professional football players compared with athlete controls. In addition, a greater length of CSP was associated with decreased performance on a list learning task (Neuropsychological Assessment Battery List A Immediate Recall, p = 0.04) and decreased test scores on a measure of estimate verbal intelligence (Wide Range Achievement Test Fourth Edition Reading Test, p = 0.02). Given the high prevalence of CSP in neuropathologically confirmed CTE in addition to the results of this study, CSP may serve as a potential early in vivo imaging marker to identify those at high risk for CTE. Future research is needed to investigate the pathomechanism underlying the development of CSP after repetitive head impacts, and its potential association with neuropathologically confirmed CTE.

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“…Cystic changes in the pineal gland are a common incidental finding, with a prevalence of up to 10 % [16,17]. As a rule they have a diameter < 1 cm, but can reach a diameter of up to 2 cm (• ▶ Fig.…”

Section: Pineal Cystsmentioning

confidence: 99%

“…No threshold has been defined in the literature; thus in the case of clinical symptoms, a neurosurgical work-up is called for (Category II). Purely morphologically, it is frequently not possi- ble to distinguish it from a pinealcytoma in the image [17].…”

Section: Pineal Cystsmentioning

confidence: 99%

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Management of Intracranial Incidental Findings on Brain MRI

Langner

Buelow

Fleck

et al. 2016

Fortschr Röntgenstr

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The wider use of MRI for imaging of the head in both research and clinical practice has led to an increasing number of intracranial incidental findings. Most of these findings have no immediate medical consequences. Nevertheless, knowledge of common intracranial incidental findings and their clinical relevance is necessary to adequately discuss the findings with the patient. Based on the author?s experiences from a large population-based study, the most common incidental MR findings in the brain will be presented, discussing their clinical relevance and giving recommendations for management according to the current literature and guidelines. Key points: ??Intracranial incidental findings are common. ??The majority of these findings have no immediate medical consequences. ??Knowledge of common incidental findings is necessary for appropriate management. Citation Format: ??Langner S, Buelow R, Fleck S et?al. Management of Intracranial Incidental Findings on Brain MRI. Fortschr R?ntgenstr 2016; 188: 1123???1133

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Incidental Findings in Youths Volunteering for Brain MRI Research

Cited by 71 publications

References 15 publications

Incidental Findings on Brain MRI: Insight from HUNT MRI - A General Population Study

Incidental Findings on Brain MRI: Insight from HUNT MRI - A General Population Study

Cavum Septi Pellucidi in Symptomatic Former Professional Football Players

Management of Intracranial Incidental Findings on Brain MRI

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