Incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers
Incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers
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DOI：
10.1001/jama.282.1.36
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发表时间：
1999-07-07
影响因子：
120.7
通讯作者：
Patronas, NJ
中科院分区：
文献类型：
--
作者：
Katzman, GL;Dagher, AP;Patronas, NJ
背景以前的报告讨论了脑磁共振成像（MRI）扫描中发现的偶发疾病，这些疾病被要求用于无关的临床问题或症状，导致疾病的选择偏倚。然而，尚未在健康人群中研究意外异常的患病率.Objective To evaluate prevalence of incident findings on brain MRI scans obtained for a healthy，symptomatic population without selection bias.Design，Setting，and Participants回顾性分析1996年5月17日至1997年7月25日期间获得的脑部MRI扫描，来自1000名志愿者，他们作为控制对象参加了美国国立卫生研究院的各种研究方案。所有参与者（年龄范围：3-83岁; 54.6%的男性）被确定为健康和无症状的医生检查和参与者的历史。主要结果测量异常的患病率在脑MRI的发现类别（无需转诊、常规转诊、紧急转诊[研究1周内]和立即转诊[研究1至数天内]），结果82%的患者MRI检查结果正常，18%的患者MRI检查结果为偶发异常，15.1%的患者无需转诊，1.8%的患者需常规转诊，1.1%的患者需紧急转诊，0%的患者需立即转诊。在紧急转诊的人群中，发现2例确诊的原发性脑肿瘤（1例可能但未确诊），其患病率至少为0.2%。结论无症状人群中存在多种异常，可提供有价值的健康人群疾病患病率信息，其中一小部分需要紧急就医和/或进一步研究。
Context Previous reports have discussed incidental disease found on brain magnetic resonance imaging (MRI) scans that had been requested for an unrelated clinical concern or symptom, resulting in a selection bias for disease. However, the prevalence of unexpected abnormalities has not been studied in a healthy population.Objective To evaluate the prevalence of incidental findings on brain MRI scans obtained for a healthy, asymptomatic population without selection bias.Design, Setting, and Participants Retrospective analysis of brain MRI scans obtained between May 17, 1996, and July 25, 1997, from 1000 volunteers who participated as control subjects for various research protocols at the National Institutes of Health. All participants (age range, 3-83 years; 54.6% male) were determined to be healthy and asymptomatic by physician examination and participant history.Main Outcome Measure Prevalence of abnormalities on brain MRI by category of finding (no referral necessary, routine referral, urgent referral [within 1 week of study], and immediate referral [within 1 to several days of study]),Results Eighty-two percent of the MRI results were normal, Of the 18% demonstrating incidental abnormal findings, 15.1% required no referral; 1.8%, routine referral; 1.1%, urgent referral; and 0%, immediate referral. In subjects grouped for urgent referral, 2 confirmed primary brain tumors (and a possible but unconfirmed third) were found, demonstrating a prevalence of at least 0.2%.Conclusion Asymptomatic subjects present with a variety of abnormalities, providing valuable information on disease prevalence in a presumed healthy population, A small percentage of these findings require urgent medical attention and/or additional studies.