title: Incidental findings on brain magnetic resonance imaging of children with sickle cell disease.
abstract: OBJECTIVE
  We describe the prevalence and range of incidental intracranial abnormalities identified through MRI of the brain in a large group of children screened for a clinical trial.
  
  
  METHODS
  We included 953 children between 5 and 14 years of age who were screened with MRI of the brain for the Silent Infarct Transfusion Trial. All had sickle cell anemia or sickle beta-null thalassemia. MRI scans were interpreted by 3 neuroradiologists. MRI scans reported to have any abnormality were reviewed by 2 study neuroradiologists. Incidental findings were classified into 4 categories, that is, no, routine, urgent, or immediate referral recommended. Cerebral infarctions and vascular lesions were not considered incidental and were excluded.
  
  
  RESULTS
  We identified 63 children (6.6% [95% confidence interval: 5.1%-8.4%]) with 68 incidental intracranial MRI findings. Findings were classified as urgent in 6 cases (0.6%), routine in 25 cases (2.6%), and no referral required in 32 cases (3.4%). No children required immediate referral. Two children with urgent findings underwent surgery in the subsequent 6 months.
  
  
  CONCLUSIONS
  In this large cohort of children, incidental intracranial findings were identified for 6.6%, with potentially serious or urgent findings for 0.6%.
authors.affiliation: Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Lori C
authors.initials: LC
authors.lastname: Jordan
authors.forename: Robert C
authors.initials: RC
authors.lastname: McKinstry
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kraut
authors.forename: William S
authors.initials: WS
authors.lastname: Ball
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Vendt
authors.forename: James F
authors.initials: JF
authors.lastname: Casella
authors.forename: Michael R
authors.initials: MR
authors.lastname: DeBaun
authors.forename: John J
authors.initials: JJ
authors.lastname: Strouse
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000175:diagnosis* / Q000209:etiology; D002544:Cerebral Infarction / Q000175:diagnosis / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging; D008297:Male; D008403:Mass Screening / Q000379:methods; D018579:Patient Selection; D015995:Prevalence; D011336:Probability; D018570:Risk Assessment