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Incidental Findings Frequently Seen in Pediatric Brain Imaging

Findings present on MRI in 6.6 percent; potentially serious incidental findings only seen in 0.6 percent

MONDAY, June 14 (HealthDay News) -- Nearly 7 percent of children involved in a magnetic resonance imaging (MRI) study had incidental intracranial findings, calling attention to issues related to counseling families when such findings arise in clinical situations, according to research published online June 14 in Pediatrics.

Lori C. Jordan, M.D., of Johns Hopkins University in Baltimore, and colleagues analyzed data from 953 children, aged 5 to 14, with sickle cell anemia or sickle β-null thalassemia. All underwent brain MRI screening as part of the Silent Infarct Transfusion Trial.

The researchers found that 63 children (6.6 percent) had incidental intracranial MRI findings; cerebral infarctions and vascular lesions were excluded and not considered incidental. Six cases were classified as urgent referral, 25 were classified as routine referral, and in 32 cases no referral was required. Two of the children with urgent referral had surgery within six months.

"Given the existing data, we recommend routine referral to a pediatric neurologist for findings that are currently asymptomatic and are of uncertain significance (such as a migrational abnormality seen on MRI scans that may predispose the subject to epilepsy, for a child who has never experienced a seizure). In addition to its clinical applications, this work may be useful for investigators using MRI for children, who must plan for incidental findings in their studies on the basis of estimated prevalence," the authors conclude.

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