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Incidental Brain MRI Findings in Children: A Systematic Review and Meta-Analysis
V Dangouloff-Ros1,2,3,4, C-J Roux5,2,3,4, G Boulouis5,4,6
1From the Pediatric Radiology Department (V.D.-R., C.-J.R., G.B., R.L., N.N., C.L., D.G., F.B., N.B., O.N.), Hôpital Necker-Enfants Malades, Paris, France Volodia.dangouloff-ros@aphp.fr.
AJNR. American Journal of Neuroradiology
|October 19, 2019
Summary
Incidental findings on children's brain MRI are common, affecting 16.4% of healthy children. However, clinically significant findings requiring treatment are rare, found in less than 1 in 38 children.
Area of Science:
- Pediatric Radiology
- Neuroimaging
- Medical Diagnostics
Background:
- Incidental findings on pediatric brain Magnetic Resonance (MR) imaging present unique challenges due to potential lifelong implications.
- The significance and management of these unexpected findings in healthy children require careful consideration.
Purpose of the Study:
- To determine the prevalence and characteristics of incidental findings identified during brain MR imaging in pediatric populations.
- To provide data that can inform clinical practice and patient counseling regarding these findings.
Main Methods:
- A systematic literature search was conducted in PubMed, EMBASE, and Cochrane databases for studies published between 1985 and July 2018.
- Inclusion criteria focused on healthy children under 21, MR imaging with ≥1.5T magnets, and methodologic quality scores of ≥10.
- Data extraction and quality assessment were performed by two independent observers, with meta-analysis of pooled data.
Main Results:
- Seven studies encompassing 5938 children revealed an overall incidental finding prevalence of 16.4% in healthy children.
- Intracranial cysts were the most common finding (10.2%), followed by nonspecific white matter hyperintensities (1.9%) and Chiari 1 malformation (0.8%).
- Findings requiring follow-up or specific treatment, such as brain tumors and cavernomas, were identified in a small percentage (<2.6%).
Conclusions:
- The prevalence of incidental findings on pediatric brain MR imaging is higher than in adults.
- Despite the high prevalence, clinically significant incidental findings requiring intervention are infrequent in children, occurring in less than 1 in 38 individuals.
