Incidental findings on MRI scans of patients presenting with audiovestibular symptoms.
BACKGROUND
The evaluation of patients presenting with audiovestibular symptoms usually includes MRI of the internal auditory meatus, the cerebellopontine angle and the brain. A significant percentage of these scans will present unexpected, incidental findings, which could have important clinical significance.


OBJECTIVE
To determine the frequency and clinical significance of incidental findings on MRI scans of patients with audiovestibular symptoms.


METHODS
A retrospective analysis of 200 serial MRI scans.


RESULTS
Gender distribution: equal. Age range: 17-82 years. One-hundred and four scans (52%) were normal and 1 scan (0.5%) demonstrated a unilateral vestibular schwannoma. Ninety-five scans (47.5%) demonstrated incidental findings. Sixty-six of these (33%) were considered of ishaemic origin and did not require further action. Five (2.5%) scans demonstrated significant findings which warranted appropriate referral; Two Gliomas (1%), 2 cases of extensive White Matter Lesions (1%), 1 lipoma (0.5%). The remaining scans demonstrated various other findings.


CONCLUSIONS
Investigation of patients with audiovestibular symptoms with MRI scans revealed incidental findings in a significant percentage (47.5%). The majority of these findings were benign warranting no further action and only 2.5% required further referral. It is the responsibility of the referring Otolaryngologist to be aware of these findings, to be able to assess their significance, to inform the patient and if needed to refer for further evaluation.
Academic Department of Oto-Rhino-Laryngology, National University of Ireland Galway, Galway, Ireland. vspap@hotmail.com.
Vasileios
V
Papanikolaou
Mohammad H
MH
Khan
Ivan J
IJ
Keogh