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Published on: November 20, 2015
Additional Relevant Intracranial Findings in Persons Screened with MR for Intracranial Aneurysms
Philippine B van Wijngaarden1, Gabriel J E Rinkel1, Irene C van der Schaaf2
1Department of Neurology and Neurosurgery, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.
Background:
Radiological screening for intracranial aneurysms (IAs) may identify other relevant intracranial findings. We investigated their prevalence on MR in persons screened for IAs.
Methods:
We included all persons who were screened for the presence of IAs with brain MRI/MRA between 1996 and 2022 because of a family history of aneurysmal subarachnoid haemorrhage (aSAH) or autosomal dominant polycystic kidney disease (ADPKD). We reviewed radiology reports of initial and repeated brain MR to identify additional intracranial findings that needed follow-up or treatment, or carried a risk of becoming symptomatic.
Results:
We included 766 persons (positive family history of aSAH: n = 681; ADPKD: n = 85) who had 1446 MRI/MRAs. At initial screening, 49 additional relevant intracranial findings were reported in 47 persons (6.1%, 95% CI 4.7-8.1%). Of all included persons, 338 (44%) underwent one (n = 154) or more (n = 184) follow-up screenings (total MRI/MRAs at follow-up: n = 680). In 15/338 persons (4.4%, 95% CI 2.7-7.2%), 16 new additional relevant findings were reported at a median follow-up duration of 10 years (IQR 5-12).
Conclusions:
Persons who are counselled for screening for IAs should be informed that there is a six percent chance of identifying an additional finding that requires follow-up or treatment, or may become symptomatic. Additionally, after 10-year follow-up screening there is a four percent chance of identifying a new additional relevant finding. The impact of such findings on quality of life needs further study.
Insights
Screening for intracranial aneurysms (IAs) can reveal other findings. Initial screening found relevant intracranial abnormalities in 6.1% of individuals, with a 4.4% chance of new findings after 10 years.
Area of Science:
- Neurology
- Radiology
- Genetics
Background:
- Radiological screening for intracranial aneurysms (IAs) is common.
- Screening may incidentally detect other intracranial abnormalities.
- Prevalence of these incidental findings on MRI was investigated.
Purpose of the Study:
- To determine the prevalence of additional relevant intracranial findings during IA screening.
- To assess the incidence of new findings on follow-up screening.
Main Methods:
- Retrospective review of brain MRI/MRA scans from 1996-2022.
- Included individuals screened for IAs due to family history of aneurysmal subarachnoid haemorrhage (aSAH) or autosomal dominant polycystic kidney disease (ADPKD).
- Radiology reports were analyzed for additional findings requiring follow-up or treatment.
Main Results:
- 766 individuals underwent 1446 MRI/MRAs.
- Initial screening identified 49 additional relevant findings in 47 individuals (6.1%).
- Follow-up screening (median 10 years) revealed 16 new findings in 15 individuals (4.4%).
Conclusions:
- Individuals screened for IAs have a 6% chance of incidental findings.
- A 4% chance exists for new findings on 10-year follow-up screening.
- Further research is needed on the impact of these findings on quality of life.
