Incidental findings on brain magnetic resonance imaging (MRI) in adults: a review of imaging spectrum, clinical significance, and management

Abstract

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.

Moving Beyond Movement: Diagnosing Functional Movement Disorder

“…Prevalence of incidental findings on brain magnetic resonance imaging (MRI) has been reported in the range of 9 to 54%, often in the range of 20 to 30%. [70][71][72] In a study of patients with functional seizures, approximately 50% of brain MRIs demonstrated incidental abnormalities, and 23% demonstrated incidental findings that could be associated with epilepsy, possibly leading to diagnostic confusion. 73 Encountering incidental findings is likely to occur when evaluating patients with FMD, and an approach to managing this is necessary.…”

The Misguided Veneration of Averageness in Clinical Neuroscience: A Call to Value Diversity over Typicality

“…Several other neuroradiological studies in healthy samples have reported incidental findings on MRI scans, though with substantial variation in the observed prevalence of observation. A recent review of these suggests that in non-clinical adult samples, the prevalence of incidental neurological findings ranges between 9 and 54% [ 4 ]. Thus, some levels of neurological ‘abnormality’ is relatively normal.…”

“…This is because children with neurological disease, learning disability, and emotional or attentional disorders were excluded from the sampling. It is also worth noting that, despite such exclusions, and as described above, many people have neurological findings that they are unaware of, perhaps at levels of over a quarter of the population [ 4 ]. Consequently, the normative samples inevitably do contain much data from individuals with neurological disorders.…”

Improved Magnetic Resonance Image Reconstruction using Compressed Sensing and Adaptive Multi Extreme Particle Swarm Optimization Algorithm

“…Magnetic resonance imaging (MRI), a non-ionizing radiation medical imaging technology [1] is widely utilized in medical procedures. However, the extensive data collection required for one image as necessitated by the Nyquist criterion [2], makes the process time-consuming, constrained by technical and physiological limitations [3] since more samples are needed for optimal resolution.…”