Incidental findings detected on magnetic resonance imaging scans of the cervical, thoracic and lumbar spine of patients prediagnosed with discopathy
Incidental findings detected on magnetic resonance imaging scans of the cervical, thoracic and lumbar spine of patients prediagnosed with discopathy
Objective: To determine the frequency and types of incidental findings on magnetic resonance imaging (MRI) scans of the cervical,
thoracic, and lumbar spine in patients with intervertebral discopathy.
Patients and Methods: This retrospective study included 1000 patients (513 females and 487 males, with a mean age of 50.5 years)
with clinically suspected intervertebral discopathy who underwent MRI. Any abnormal findings and congenital anomalies/anatomical
variations unrelated to the primary complaint were referred to as incidental findings. Frequency distributions of the assessed imaging
characteristics were calculated.
Results: Of the 1000 patients, 192 (19.2%) patients were presented with incidental findings. The positive findings in the thoracic spine
(26%) were higher than those in the lumbar (19.8%) and cervical spine (13.7%). The study found vertebral haemangioma to be the
most common finding, followed by Schmorl’s nodes in the thoracic and lumbar spine. Thyroid nodules constituted the most common
finding in the cervical spine, followed by vertebral haemangioma. Renal cysts in the thoracic and lumbar spine and thyroid nodules in
the cervical spine were the most frequent extraspinal findings.
Conclusion: Incidental findings are commonly detected during MRI examination of intervertebral discs, and most are benign findings.
However, incidental findings including clinically essential findings can alter the patient’s treatment or affect the patient’s life. Therefore,
it is crucial to systematically evaluate MRIs without focusing solely on the spine and report incidental findings detected on MRI.
___
- [1] Wagner SC, Morrison WB, Carrino JA, Schweitzer ME,
Nothnagel H. Picture archiving and communication system:
effect on reporting of incidental findings. Radiology 2002;
225: 500-5. doi:10.1148/radiol.225.201.1731
- [2] Yap KKH, Ramaseshan G, Sutherland T, Shafik‐Eid R,
Taubman K, Schlicht S. Prevalence of incidental or unexpected
findings on low‐dose CT performed during routine SPECT/
CT nuclear medicine studies. J Med Imaging Radiat Oncol
2015; 59: 26-33. doi:10.1111/1754-9485.12254
- [3] Kamath S, Jain N, Goyal N, Mansour R, Mukherjee K.
Incidental findings on MRI of the spine. Clin Radiol 2009; 64:
353-61. doi: 10.1016/j.crad.2008.09.010
- [4] Park H-J, Jeon Y-H, Rho M-H, et al. Incidental findings of
the lumbar spine at MRI during herniated intervertebral disk
disease evaluation. Am J Roentgenol 2011; 196: 1151-5. doi:
10.2214/AJR.10.5457.
- [5] Cieszanowski A, Maj E, Kulisiewicz P, et al. Non-contrastenhanced
whole-body magnetic resonance imaging in the
general population: the incidence of abnormal findings
in patients 50 years old and younger compared to older
subjects. PLoS One 2014; 9: e107840. doi: 10.1371/journal.
pone.0107840
- [6] Zidan MM, Hassan IA, Elnour AM, et al. Extraspinal incidental
findings on routine MRI of Cervical spine. Glob Adv Res J
Med Med Sci 2017; 6: 234-9. http://garj.org/garjmms
- [7] Zidan MM, Hassan IA, Elnour AM, et al. Incidental extraspinal
findings in the thoracic spine during magnetic resonance
imaging of intervertebral discs. J Clin Imag Sci 2019; 9. doi:
10.25259/JCIS_50_2019
- [8] Quattrocchi CC, Giona A, Di Martino AC, et al. Extraspinal
incidental findings at lumbar spine MRI in the general
population: a large cohort study. Insights into Imag 2013; 4:
301-8. doi: 10.1007/s13244.013.0234-z
- [9] Levine D, Brown DL, Andreotti RF, et al. Management of
asymptomatic ovarian and other adnexal cysts imaged at US:
Society of Radiologists in Ultrasound Consensus Conference
Statement. Radiology 2010; 256: 943-54. doi: 10.1097/
RUQ.0b013e3181f09099
- [10] Eroğlu A, Yılmaz İ. Lomber Diskopatili Hastalarda Lomber
Spinal MR İncelemede Görülen Rastlantısal Lezyonlar.
Pamukkale Tıp Dergisi 2018 ;11: 309-13. doi.org/10.31362/
patd.451713
- [11] Ibrahim H, Elsadawy MEI. Incidental findings in lumbar
spine MRI: their prevalence and potential impact on patient
management. Egyp J Radiol and Nuclear Med 2019; 50: 1-5.
doi:10.1186/s43055.019.0059-y
- [12] Sobhan M, Samiee M, Asgari Y, Ahmadi M. Incidental
findings of the lumbar spine at MRI in patients diagnosed
with discopathy. Int J Med Imag 2016; 4: 44. doi: 10.11648/j.
ijmi.20160405.12
- [13] Barzin M, Maleki I. Incidence of vertebral hemangioma on
spinal magnetic resonance imaging in Northern Iran. PJBS
2009; 12: 542-4. doi: 10.3923/pjbs.2009.542.544
- [14] Langdown AJ, Grundy JR, Birch NC. The clinical relevance
of Tarlov cysts. Clinical Spine Surg 2005; 18: 29-33. doi:
10.1097/01.bsd.000.013.3495.78245.71
- [15] Tuncel SA, Çaglı B, Tekataş A, Kırıcı MY, Ünlü E, Gençhellaç
H. Extraspinal incidental findings on routine MRI of lumbar
spine: prevalence and reporting rates in 1278 patients. Korean
J Radiol 2015; 16: 866-73. doi: 10.3348/kjr.2015.16.4.866
- [16] Zeh OF, Goujou EG, Awana AP, et al. Extraspinal incidental
findings at lumbar spine magnetic resonance imaging in two
hospitals: Prevalence and clinical importance. Open J Radiol
2017; 7: 241-8. doi: 10.4236/ojrad.2017.74026
- [17] Dilli A, Ayaz UY, Turanlı S, et al. Incidental extraspinal findings
on magnetic resonance imaging of intervertebral discs. Arc
Med Sci 2014; 10: 757. doi: 10.5114/aoms.2014.44868
- [18] Natsis K, Piagkou M, Skotsimara A, Protogerou V, Tsitouridis
I, Skandalakis P. Horseshoe kidney: a review of anatomy and
pathology. Surg Radiol Anat 2014; 36: 517-26. doi: 10.1007/
s00276.013.1229-7
- [19] Green L. PACS: effect on incidental findings. Radiol Man
2004; 26: 26-9. PMID: 14994834
- [20] Ezzat S, Sarti DA, Cain DR, Braunstein GD. Thyroid
incidentalomas: prevalence by palpation and ultrasonography.
Arch Int Med 1994; 154: 1838-40. doi: 10.1001/
archinte.154.16.1838
- [21] Ramadorai UE, Hire JM, DeVine JG. Magnetic resonance
imaging of the cervical, thoracic, and lumbar spine in children:
spinal incidental findings in pediatric patients. Glob Spine J
2014; 4: 223-8. doi: 10.1055/s-0034.138.7179.