Incidental findings on brain magnetic resonance imaging of children with sickle cell disease.

Jordan LC, McKinstry RC, Kraut MA, Ball WS, Vendt BA, Casella JF, DeBaun MR, Strouse JJ, Silent Infarct Transfusion Trial Investigators
Pediatrics. 2010 126 (1): 53-61

PMID: 20547639 · PMCID: PMC3153884 · DOI:10.1542/peds.2009-2800

OBJECTIVE - We describe the prevalence and range of incidental intracranial abnormalities identified through MRI of the brain in a large group of children screened for a clinical trial.

METHODS - We included 953 children between 5 and 14 years of age who were screened with MRI of the brain for the Silent Infarct Transfusion Trial. All had sickle cell anemia or sickle beta-null thalassemia. MRI scans were interpreted by 3 neuroradiologists. MRI scans reported to have any abnormality were reviewed by 2 study neuroradiologists. Incidental findings were classified into 4 categories, that is, no, routine, urgent, or immediate referral recommended. Cerebral infarctions and vascular lesions were not considered incidental and were excluded.

RESULTS - We identified 63 children (6.6% [95% confidence interval: 5.1%-8.4%]) with 68 incidental intracranial MRI findings. Findings were classified as urgent in 6 cases (0.6%), routine in 25 cases (2.6%), and no referral required in 32 cases (3.4%). No children required immediate referral. Two children with urgent findings underwent surgery in the subsequent 6 months.

CONCLUSION - In this large cohort of children, incidental intracranial findings were identified for 6.6%, with potentially serious or urgent findings for 0.6%.

MeSH Terms (19)

Adolescent Anemia, Sickle Cell Brain Brain Diseases Cerebral Infarction Child Child, Preschool Confidence Intervals Female Follow-Up Studies Humans Incidental Findings Magnetic Resonance Imaging Male Mass Screening Patient Selection Prevalence Probability Risk Assessment

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