Up to 21% of children have incidental findings on brain MRI—but few are dangerous
Incidental findings are common on pediatric brain MRI exams, but the vast majority are not life-threatening, according to a large study published Monday.
University of California, San Francisco, researchers pored over scans taken from more than 11,500 U.S. children ages 9 to 10 for their findings, shared in JAMA Neurology. Up to 21% of those images showed abnormalities, such as cysts. Only 4% of children, however, had findings that were clinically significant.
“From examining brain MRIs in this large, demographically diverse sample of U.S. kids, now we know with good statistical reliability how common various brain abnormalities are in the general population,” senior author Leo Sugrue, MD, PhD, associate professor of radiology at UCSF, said in a university news piece.
These results are among the first to come out of the nationwide Adolescent Brain Cognitive Development (ABCD) study, which is currently the largest long-term investigation of child health and brain development.
For this arm of the study, the researchers looked over baseline structural MRI exams from 11,769 children. Overall, 2,464 (21.4%) showed an incidental finding, most were considered category 1 (no abnormal findings) or 2 (no referral recommended).
There were 431 (3.7%) that required consideration for referral (category 3) with 20 (0.2%) deemed necessary for immediate referral (category 4).
Of those labeled for potential referral, most (0.9%) were an abnormality associated with epilepsy, followed by white matter findings (0.5%) and arachnoid/intraventricular cysts with mass effect (0.2%).
Out of the 20 incidental findings sent for immediate referral, seven were mass-like regions suggesting glial neoplasm, six cases of hydrocephalus, and three instances of severe Chiari I malformation, among others.
According to the finalized results, 1 in 25 children have findings on brain MRI that require clinical follow-up and 1 in 500 shows an abnormality necessitating urgent attention. These figures may assist both clinical care and research efforts, the authors explained.
“From a clinical perspective, knowing the prevalence of specific IFs can help contextualize the importance of similar findings on clinical imaging,” they concluded in the study. “From a research perspective, knowing the overall rate of IFs can help in counseling research participants during the informed consent process.”
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.