There is an ongoing debate about how to handle incidental findings (IF) detected in healthy individuals who participate in research-driven magnetic resonance imaging (MRI) studies. There are currently no established guidelines regarding their management.
We prospectively assessed the frequency of IF in 206 young healthy volunteers who additionally underwent structural MRIs of the whole brain as part of a scientific MRI protocol.
Assessment of the structural MRI by 2 board-certified neuroradiologists revealed IF in 19% of the subjects (n = 39). In approximately half of these subjects (n = 21), these findings were of potential clinical relevance (eg, arteriovenous malformations, cavernomas, pituitary abnormalities) and required further diagnostic investigations. None of these potentially relevant IF prompted immediate active medical treatment.
Incidental findings are very frequent in young healthy volunteers. Because many of the IF require further diagnostic workup, standardized procedures for MRI and the handling of these images are mandatory to ensure competent clinical management.
From the *Department of Neurology, Christian-Albrechts-University, Kiel, Germany; †Danish Research Centre for Magnetic Resonance, Hvidovre University Hospital, Copenhagen, Denmark; and ‡Institute of Neuroradiology, University Hospital of Schleswig-Holstein, Kiel, Germany.
Received for publication December 23, 2009; accepted February 5, 2010.
Reprints: Stephan Ulmer, MD, Institute of Neuroradiology, University Hospital of Schleswig-Holstein, Schittenhelmstrasse 10, 24105 Kiel, Germany (e-mail: email@example.com).