随着大脑磁共振成像(MRI)的体积和保真度的增加,对偶然发现的观察也可能增加。我们进行了系统评价和荟萃分析,以确定各种偶然发现的患病率。
PubMed/MEDLINE,EMBASE和SCOPUS从成立到2021年5月24日进行了搜索。我们确定了6536篇引文,包括34项研究的35篇报告,包括40,777名参与者。进行了比例的荟萃分析,每个发现的年龄分层估计值来自年龄调整后的非线性模型.
在423/35,706名参与者中观察到血管异常(9.1/1000扫描,95CI5.2-14.2),范围从1岁儿童的2/1000扫描(95CI0-7)到80岁儿童的16/1000扫描(95CI1-43)。其中,204/34,306是动脉瘤(3.1/1000扫描,95CI1-6.3),范围从1岁时的0/1000扫描(95CI0-5)到60岁时的6/1000扫描(95CI3-9)。在456/39,040名参与者中观察到肿瘤异常(11.9/1000扫描,95CI7.5-17.2),范围从1岁的0.2/1000扫描(95CI0-10)到80岁的34/1000扫描(95CI12-66)。脑膜瘤是最常见的,在246/38,076名参与者中(5.3/1000扫描,95CI2.3-9.5),范围从1岁儿童的0/1000扫描(95CI0-2)到80岁儿童的17/1000扫描(95CI4-37)。在109/27,408名参与者中观察到Chiari畸形(3.7/1000扫描,95CI1.8-6.3),松果体囊肿1176/32,170(9/1000扫描,95CI1.8-21.4)和蛛网膜囊肿在414/36,367(8.5/1000扫描,95CI5.8-11.8)。
偶然发现在脑部MRI上很常见,可能会导致大量资源支出和患者焦虑,但通常没有临床意义。
As the volume and fidelity of magnetic resonance imaging (MRI) of the brain increase, observation of incidental findings may also increase. We performed a systematic
review and meta-analysis to determine the prevalence of various incidental findings.
PubMed/MEDLINE, EMBASE and SCOPUS were searched from inception to May 24, 2021. We identified 6536 citations and included 35 reports of 34 studies, comprising 40,777 participants. A meta-analysis of proportions was performed, and age-stratified estimates for each finding were derived from age-adjusted non-linear models.
Vascular abnormalities were observed in 423/35,706 participants (9.1/1000 scans, 95%CI 5.2-14.2), ranging from 2/1000 scans (95%CI 0-7) in 1-year-olds to 16/1000 scans (95%CI 1-43) in 80-year-olds. Of these, 204/34,306 were aneurysms (3.1/1000 scans, 95%CI 1-6.3), which ranged from 0/1000 scans (95%CI 0-5) at 1 year of age to 6/1000 scans (95%CI 3-9) at 60 years. Neoplastic abnormalities were observed in 456/39,040 participants (11.9/1000 scans, 95%CI 7.5-17.2), ranging from 0.2/1000 scans (95%CI 0-10) in 1-year-olds to 34/1000 scans (95%CI 12-66) in 80-year-olds. Meningiomas were the most common, in 246/38,076 participants (5.3/1000 scans, 95%CI 2.3-9.5), ranging from 0/1000 scans (95%CI 0-2) in 1-year-olds to 17/1000 scans (95%CI 4-37) in 80-year-olds. Chiari malformations were observed in 109/27,408 participants (3.7/1000 scans, 95%CI 1.8-6.3), pineal cysts in 1176/32,170 (9/1000 scans, 95%CI 1.8-21.4) and arachnoid cysts in 414/36,367 (8.5/1000 scans, 95%CI 5.8-11.8).
Incidental findings are common on brain MRI and may result in substantial resource expenditure and patient anxiety but are often of little clinical significance.