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Extraspinal Incidental Findings on Routine MRI of Lumbar Spine: Prevalence and Reporting Rates in 1278 Patients.

Tuncel SA, Çaglı B, Tekataş A, Kırıcı MY, Ünlü E, Gençhellaç H - Korean J Radiol (2015)

Bottom Line: A total of 253 IFs were found in 241 patients (18.8% of 1278).Extraspinal IFs are commonly detected during a routine lumbar MRI, and many of these findings are not clinically significant.However, IFs including clinically important findings are occasionally omitted from formal radiological reports.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Trakya University Faculty of Medicine, Balkan Campus, Edirne 22000, Turkey.

ABSTRACT

Objective: The aim of the present study was to determine the prevalence and reporting rate of incidental findings (IF) in adult outpatients undergoing lumbar magnetic resonance imaging (MRI).

Materials and methods: Re-evaluation of a total of 1278 lumbar MRI images (collected from patients with a mean age of 50.5 years, range 16-91 years) captured between August 2010-August 2011 was done by a neuroradiologist and a musculoskeletal radiologist. IFs were classified according to organ or system (liver, gallbladder, kidney, bladder, uterus, ovary, lymph node, intestine and aorta). The rate of reporting of a range of IF was examined. The outcome of each patient's treatment was evaluated based on review of hospital records and by telephone interviews.

Results: A total of 253 IFs were found in 241 patients (18.8% of 1278). Among these, clinically significant IFs (n = 34) included: 2 renal masses (0.15%), 2 aortic aneurysms (0.15%), 2 cases of hydronephrosis (0.15%), 11 adrenal masses (0.86%), 7 lymphadenopathies (0.55%), 6 cases of endometrial or cervical thickening (0.47%), 1 liver hemangioma (0.08%), 1 pelvic fluid (0.08%) and 2 ovarian dermoid cysts (0.15%). Overall, 28% (71/253) of IFs were included in the clinical reports, while clinically significant findings were reported in 41% (14/34) of cases.

Conclusion: Extraspinal IFs are commonly detected during a routine lumbar MRI, and many of these findings are not clinically significant. However, IFs including clinically important findings are occasionally omitted from formal radiological reports.

No MeSH data available.


Related in: MedlinePlus

Sample images from genital system.A. Ovarian dermoid cyst (hyperintense lesion [arrow] on sagittal T1-weighted image) with central dermoid nodule (asterisk), which is verified after surgery. B. Endometrial thickening (asterisk). C. Uterine fibroid (encircled) on T2-weighted sagittal images.
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Figure 1: Sample images from genital system.A. Ovarian dermoid cyst (hyperintense lesion [arrow] on sagittal T1-weighted image) with central dermoid nodule (asterisk), which is verified after surgery. B. Endometrial thickening (asterisk). C. Uterine fibroid (encircled) on T2-weighted sagittal images.

Mentions: About 80% (9/11) of renal cysts were reported to be larger in size (> 5 cm), while rate was only 15% (11/71) in smaller sized cysts (< 5 cm). A similar situation was seen in ovarian cysts: the reporting rate was 50% (2/4) for cysts larger than 5 cm, while the reporting rate was only 29% (7/24) if the cyst was smaller than 5 cm. Alternately, a 50% (18/36) reporting rate was found for fibroids smaller than 4 cm (Fig. 1C). A diagnosis of dermoid cyst was confirmed after surgery in two ovarian cyst cases (one 7 cm in diameter and the other 8 cm in diameter) that were identified as dermoid cysts based on radiological evaluation (Fig. 1A). The surgical record regarding one of these cases was not available in the hospital records and the patient could not be reached by phone.


Extraspinal Incidental Findings on Routine MRI of Lumbar Spine: Prevalence and Reporting Rates in 1278 Patients.

Tuncel SA, Çaglı B, Tekataş A, Kırıcı MY, Ünlü E, Gençhellaç H - Korean J Radiol (2015)

Sample images from genital system.A. Ovarian dermoid cyst (hyperintense lesion [arrow] on sagittal T1-weighted image) with central dermoid nodule (asterisk), which is verified after surgery. B. Endometrial thickening (asterisk). C. Uterine fibroid (encircled) on T2-weighted sagittal images.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499552&req=5

Figure 1: Sample images from genital system.A. Ovarian dermoid cyst (hyperintense lesion [arrow] on sagittal T1-weighted image) with central dermoid nodule (asterisk), which is verified after surgery. B. Endometrial thickening (asterisk). C. Uterine fibroid (encircled) on T2-weighted sagittal images.
Mentions: About 80% (9/11) of renal cysts were reported to be larger in size (> 5 cm), while rate was only 15% (11/71) in smaller sized cysts (< 5 cm). A similar situation was seen in ovarian cysts: the reporting rate was 50% (2/4) for cysts larger than 5 cm, while the reporting rate was only 29% (7/24) if the cyst was smaller than 5 cm. Alternately, a 50% (18/36) reporting rate was found for fibroids smaller than 4 cm (Fig. 1C). A diagnosis of dermoid cyst was confirmed after surgery in two ovarian cyst cases (one 7 cm in diameter and the other 8 cm in diameter) that were identified as dermoid cysts based on radiological evaluation (Fig. 1A). The surgical record regarding one of these cases was not available in the hospital records and the patient could not be reached by phone.

Bottom Line: A total of 253 IFs were found in 241 patients (18.8% of 1278).Extraspinal IFs are commonly detected during a routine lumbar MRI, and many of these findings are not clinically significant.However, IFs including clinically important findings are occasionally omitted from formal radiological reports.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Trakya University Faculty of Medicine, Balkan Campus, Edirne 22000, Turkey.

ABSTRACT

Objective: The aim of the present study was to determine the prevalence and reporting rate of incidental findings (IF) in adult outpatients undergoing lumbar magnetic resonance imaging (MRI).

Materials and methods: Re-evaluation of a total of 1278 lumbar MRI images (collected from patients with a mean age of 50.5 years, range 16-91 years) captured between August 2010-August 2011 was done by a neuroradiologist and a musculoskeletal radiologist. IFs were classified according to organ or system (liver, gallbladder, kidney, bladder, uterus, ovary, lymph node, intestine and aorta). The rate of reporting of a range of IF was examined. The outcome of each patient's treatment was evaluated based on review of hospital records and by telephone interviews.

Results: A total of 253 IFs were found in 241 patients (18.8% of 1278). Among these, clinically significant IFs (n = 34) included: 2 renal masses (0.15%), 2 aortic aneurysms (0.15%), 2 cases of hydronephrosis (0.15%), 11 adrenal masses (0.86%), 7 lymphadenopathies (0.55%), 6 cases of endometrial or cervical thickening (0.47%), 1 liver hemangioma (0.08%), 1 pelvic fluid (0.08%) and 2 ovarian dermoid cysts (0.15%). Overall, 28% (71/253) of IFs were included in the clinical reports, while clinically significant findings were reported in 41% (14/34) of cases.

Conclusion: Extraspinal IFs are commonly detected during a routine lumbar MRI, and many of these findings are not clinically significant. However, IFs including clinically important findings are occasionally omitted from formal radiological reports.

No MeSH data available.


Related in: MedlinePlus