Journal
PEDIATRICS
Volume 126, Issue 1, Pages 53-61Publisher
AMER ACAD PEDIATRICS
DOI: 10.1542/peds.2009-2800
Keywords
incidental findings; magnetic resonance imaging; brain imaging; children; sickle cell disease
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Funding
- National Institute of Neurological Disorders and Stroke [U01-NS-042804, K23NS062110]
- National Heart, Lung, and Blood Institute [K23HL078819]
- Doris Duke Charitable Foundation
- American Society of Hematology
- National Institutes of Health (NIH)
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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%. Pediatrics 2010;126:53-61
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