JAMA Neurol:健康儿童脑部磁共振偶然发现率及其临床意义

2021-03-23 MedSci原创 MedSci原创

在一般儿童群体中,脑部MRI中偶然发现率超过20%,多数偶然发现不具有潜在临床意义

影像学检查过程中的偶然发现(IFs)是成像过程中发现的意外异常,包括正常解剖变异,甚至需要紧急医疗干预的发现,临床或研究过程中的偶然发现较为常见,特别是在脑磁共振成像(MRI)过程中。最近的荟萃分析显示,健康儿童脑磁共振成像偶然发现率约为16%。
近日研究人员就非临床儿科人群脑MRI偶然发现率进行了考察,重点关注建议临床转诊的偶然发现率。
青少年大脑认知发展(ABCD)研究在美国开展,是至今为止最大的基于人口的脑发育与儿童健康纵向观察研究,在2016年9月1日至2018年11月15日之间进行,包含11810名9至10岁的儿童, 参与者进行脑MRI神经成像。随后由委员会认证的神经放射科医师对成像结果中的偶然发现进行审查及分类(第1类,无异常发现;第2类,不建议转诊;第3类,考虑转诊;第4类,考虑立即转诊)。存在严重感觉、智力、医学或神经系统疾病的儿童不包含在研究范围内。研究的主要终点为4类偶然异常百分比,以及特定偶然发现的患病率。
 
11679名儿童完成MRI成像,其中52.1%为男孩,平均年龄9.9岁。2464名参与者(21.1%)存在偶然发现,其中2013名儿童(17.2%)的偶然发现归为2类,431名(3.7%)归为3类,20名(0.2%)归为4类。最常见的IFS包括松果体囊肿(910例,7.8%),中线后窝囊性病变(225例,1.9%)以及发育性静脉异常(220例,1.9%)。单胎妊娠、双胎妊娠、同卵和双卵妊娠之间的IFs总发生率没有显著差异。
在一般儿童群体中,脑部MRI中偶然发现率超过20%,多数偶然发现不具有潜在临床意义
 
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    2021-06-06 yinhl1978
  2. [GetPortalCommentsPageByObjectIdResponse(id=2001271, encodeId=595d20012e1f5, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sun Jun 06 16:24:22 CST 2021, time=2021-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1341713, encodeId=47751341e130a, content=<a href='/topic/show?id=24b8e37529a' target=_blank style='color:#2F92EE;'>#磁共振#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73752, encryptionId=24b8e37529a, topicName=磁共振)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Thu Mar 25 10:24:22 CST 2021, time=2021-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036539, encodeId=26d1103653943, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Mar 23 22:24:22 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=950454, encodeId=a640950454f6, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Mar 23 20:32:24 CST 2021, time=2021-03-23, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=2001271, encodeId=595d20012e1f5, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sun Jun 06 16:24:22 CST 2021, time=2021-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1341713, encodeId=47751341e130a, content=<a href='/topic/show?id=24b8e37529a' target=_blank style='color:#2F92EE;'>#磁共振#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73752, encryptionId=24b8e37529a, topicName=磁共振)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Thu Mar 25 10:24:22 CST 2021, time=2021-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036539, encodeId=26d1103653943, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Mar 23 22:24:22 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=950454, encodeId=a640950454f6, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Mar 23 20:32:24 CST 2021, time=2021-03-23, status=1, ipAttribution=)]
    2021-03-23 旺医

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  4. [GetPortalCommentsPageByObjectIdResponse(id=2001271, encodeId=595d20012e1f5, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sun Jun 06 16:24:22 CST 2021, time=2021-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1341713, encodeId=47751341e130a, content=<a href='/topic/show?id=24b8e37529a' target=_blank style='color:#2F92EE;'>#磁共振#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73752, encryptionId=24b8e37529a, topicName=磁共振)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Thu Mar 25 10:24:22 CST 2021, time=2021-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036539, encodeId=26d1103653943, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Mar 23 22:24:22 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=950454, encodeId=a640950454f6, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Mar 23 20:32:24 CST 2021, time=2021-03-23, status=1, ipAttribution=)]
    2021-03-23 jyzxjiangqin

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    0

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