Intracranial incidental findings on brain MR images in a pediatric neurology practice: a retrospective study.
OBJECTIVE
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: approximately 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.
Gupta
Surya N
SN
Section of Child Neurology, Department of Pediatrics, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA. guptasn@temple.edu
Belay
Brook
B
D000293:Adolescent; D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data* / Q000639:trends; D008297:Male; D008511:Medicine / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends; D009462:Neurology / Q000706:statistics & numerical data / Q000639:trends; D010372:Pediatrics / Q000706:statistics & numerical data / Q000639:trends; D010817:Physician-Patient Relations; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D012017:Referral and Consultation / Q000706:statistics & numerical data / Q000639:trends; D012189:Retrospective Studies; D013038:Specialization