Prevalence and clinical potential of extraspinal incidental findings in lumbosacral spine MRI of patients with suspected disc diseases

  • Sameeah Abdulrahman Rashid Department of Surgery, College of Medicine, Hawler Medical University, Erbil, Iraq
Keywords: incidental finding, lumbar spine, MRI
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Abstract

BACKGROUND Incidental findings could be observed in organs close to the spine while reporting lumbosacral spine magnetic resonance imaging (MRI). This study aimed to report the prevalence and clinical potential of extraspinal incidental findings in lumbosacral MRI of patients with suspected disc diseases.

METHODS This single-centered cross-sectional study was carried out on 420 consecutive adult patients who underwent lumbar spine MRI for suspected disc disease from January to July 2019. The MRI was checked for the presence of extraspinal incidental findings, and each finding was categorized according to the body organ and its clinical significance. Each MRI plane that best displayed the findings was recorded, and the association between the findings and patient's age and sex was determined.

RESULTS Of 420 samples, 135 cases showed extraspinal findings (32.1%), and 7.6% of the patients displayed suspicious lesions. The urinary tract was the most common system (18.6%) to display both clinically significant (5.0%) and benign findings (13.6%), and the axial MRI section was the plane which showed most of the incidental findings. Incidental findings in any body system were rarely found in the younger patients. Females had significantly higher benign findings than males (p = 0.002).

CONCLUSIONS The prevalence of extraspinal findings in lumbosacral spine MRI is high, and some are significant. Most findings are related to the urinary tract and best displayed in the axial plane.

References

  1. Berland LL, Silverman SG, Gore RM, Mayo-Smith WW, Megibow AJ, Yee J, et al. Managing incidental findings on abdominal CT: white paper of the ACR incidental findings committee. J Am Coll Radiol. 2010;7(10):754-73. https://doi.org/10.1016/j.jacr.2010.06.013

  2. Ells C, Thombs BD. The ethics of how to manage incidental findings. CMAJ. 2014;186(9):655-6. https://doi.org/10.1503/cmaj.140136

  3. Park HJ, Jeon YH, Rho MH, Lee EJ, Park NH, Park SI, et al. Incidental findings of the lumbar spine at MRI during herniated intervertebral disk disease evaluation. Am J Roentgenol. 2011;196(5):1151-5. https://doi.org/10.2214/AJR.10.5457

  4. Varghese B, Babu AC, Kumar A, Priya PS, John JS, Noufal M, et al. Cross-sectional study on incidental spinal findings in magnetic resonance imaging lumbar spine of patients with low back pain. West Afr J Radiol. 2017;24(1):38-44. https://doi.org/10.4103/1115-3474.198091

  5. Vernooij MW, Ikram MA, Tanghe HL, Vincent AJ, Hofman A, Krestin GP, et al. Incidental findings on brain MRI in the general population. N Engl J Med. 2007;357(18):1821-8. https://doi.org/10.1056/NEJMoa070972

  6. Wagner SC, Morrison WB, Carrino JA, Schweitzer ME, Nothnagel H. Picture archiving and communication system: effect on reporting of incidental findings. Radiology. 2002;225(2):500-5. https://doi.org/10.1148/radiol.2252011731

  7. Quattrocchi CC, Giona A, Di Martino AC, Errante Y, Scarciolla L, Mallio CA, et al. Extra-spinal incidental findings at lumbar spine MRI in the general population: a large cohort study. Insights Imaging. 2013;4(3):301-8. https://doi.org/10.1007/s13244-013-0234-z

  8. Lee SY, Landis MS, Ross IG, Goela A, Leung AE. Extraspinal findings at lumbar spine CT examinations: prevalence and clinical importance. Radiology. 2012;263(2):502-9. https://doi.org/10.1148/radiol.12112152

  9. Maxwell AW, Keating DP, Nickerson JP. Incidental abdominopelvic findings on expanded field-of-view lumbar spinal MRI: frequency, clinical importance, and concordance in interpretation by neuroimaging and body imaging radiologists. Clin Radiol. 2015;70(2):161-7. https://doi.org/10.1016/j.crad.2014.10.016

  10. 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(4):866-73. https://doi.org/10.3348/kjr.2015.16.4.866

  11. Ibrahim H, Elsadawy ME. Incidental findings in lumbar spine MRI: their prevalence and potential impact on patient management. Egypt J Radiol Nucl Med. 2019;50(59). https://doi.org/10.1186/s43055-019-0059-y

  12. Zidan MMA, Hassan IA, Elnour AM, Ali WM, Mahmoud MZ, Alonazi B, et al. Incidental extraspinal findings in the lumbar spine during magnetic resonance imaging of intervertebral discs. Heliyon. 2018;4(9):e00803. https://doi.org/10.1016/j.heliyon.2018.e00803

  13. Qasim HA, Al-Bayati H, Mahmoud NA. Incidental finding during MRI evaluation of lumbosacral disc prolapse in adults in Al-Hilla Teaching Hospital. Med J Babylon. 2017;14(3):537-49.

  14. Sobhan M, Samiee M, Asgari Y, Ahmadi M. Incidental findings of the lumbar spine at MRI in patients diagnosed with discopathy. Int J Med Imaging. 2016;4(5):44-7. https://doi.org/10.11648/j.ijmi.20160405.12

  15. Ozveren B, Onganer E, Türkeri LN. Simple renal cysts: prevalence, associated risk factors and follow-up in a health screening cohort. Urol J. 2016;13(1):2569-75. https://doi.org/10.22037/uj.v13i1.3216

  16. Stewart EA, Cookson CL, Gandolfo RA, Schulze-Rath R. Epidemiology of uterine fibroids: a systematic review. BJOG. 2017;124(10):1501-12. https://doi.org/10.1111/1471-0528.14640

  17. Gebara NV, Meltzer DE. Extraspinal findings on lumbar spine MR imaging. J Radiol Case Rep. 2009;3(8):5-13. https://doi.org/10.3941/jrcr.v3i8.213

  18. Wilken D, Baur X, Barbinova L, Preisser A, Meijer E, Rooyackers J, et al. What are the benefits of medical screening and surveillance? Eur Respir Rev. 2012;21(124):105-111. https://doi.org/10.1183/09059180.00005011

Published
2021-12-23
How to Cite
1.
Rashid SA. Prevalence and clinical potential of extraspinal incidental findings in lumbosacral spine MRI of patients with suspected disc diseases. Med J Indones [Internet]. 2021Dec.23 [cited 2022Jul.7];30(4):256-63. Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/5550
Section
Clinical Research