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The prevalence of incidental findings on pelvis MRI of 8–13-year-old children

Pediatric Research volume 93, pages 2045–2050 (2023)Cite this article

Abstract

Background

The prevalence and clinical relevance of incidental findings (IF(s)) on imaging assessing the pelvis in children has not been well documented.

Methods

Three-thousand two-hundred thirty-one children (mean age 10.2 (range 8.6–12.9) years) were evaluated with MRI of the hips, pelvis, and lumbar spine, as part of a prospective population-based pediatric cohort study. Scans were reviewed by trained medical staff for abnormalities. IFs were categorized by clinical relevance and need for further clinical evaluation.

Results

8.3% (n = 267) of children featured at least one IF. One or more musculoskeletal IFs were found in 7.9% (n = 254) of children, however, only 0.8% (n = 2) of musculoskeletal IFs required clinical evaluation. Most frequent abnormalities were simple bone cysts 6.0% (n = 195), chondroid lesions 0.6% (n = 20), and perineural cysts 0.5% (n = 15). Intra-abdominal IFs were detected in 0.5% (n = 17) of children, with over half (n = 9) of these requiring evaluation. The three most common intra-abdominal IFs were a duplex collecting system 0.09% (n = 3), significant ascites 0.06% (n = 2), and hydroureteronephrosis 0.06% (n = 2).

Conclusions

IFs on MRI of the lower abdominal and hip region are relatively common in children aged 8–13 years, most of these can be confidently categorized as clinically irrelevant without the need for additional clinical or radiologic follow up.

Impact

  • Our research contributes greatly to the knowledge of the prevalence of (asymptomatic) pathology in children. We evaluated MR images of 3231 children, covering hip joints, pelvic skeleton, lower and mid-abdomen, and lumbar and lower thoracic spine as part of a population study.

  • One or more musculoskeletal incidental finding were found in 7.9% of children. Most of these can be confidently categorized as clinically irrelevant without the need for additional follow up. However 0.8% of musculoskeletal findings required further evaluation.

  • Intra-abdominal incidental findings were detected in 0.5% of children, with over half of the abdominal and urogenital findings requiring further evaluation.

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Fig. 1: Figure 1 shows examples of bone lesions on coronal T2 FS Cube images.
Fig. 2: Figure 2 shows examples of renal abnormalities found on coronal T2 FS Cube images.
Fig. 3: Figure 3 shows images of a 10-year-old girl with a teratoma.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Sullivan, J. W. O., Muntinga, T., Grigg, S. & Ioannidis, J. P. A. Prevalence and outcomes of incidental imaging findings: umbrella review. BMJ 361, k2387 (2018).

    Article  Google Scholar 

  2. Hitzeman, N. & Cotton, E. Incidentalomas: Initial Management. Am. Fam. Physician 90, 784–789 (2014).

    PubMed  Google Scholar 

  3. Bunnik, E. M. & Vernooij, M. W. Incidental findings in population imaging revisited. Eur. J. Epidemiol. 31, 1–4 (2016).

    Article  PubMed  PubMed Central  Google Scholar 

  4. Illes, J. et al. Incidental findings in brain imaging research. Science (80-) 311, 783–784 (2006).

    Article  CAS  Google Scholar 

  5. Ikram, M. A. et al. The Rotterdam Scan Study: design update 2016 and main findings. Eur. J. Epidemiol. 30, 1299–1315 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  6. Jaddoe, V. W. V. et al. The generation R study: Design and cohort update 2012. Eur. J. Epidemiol. 27, 739–756 (2012).

    Article  PubMed  Google Scholar 

  7. Jansen, P. et al. Incidental findings on brain imaging in the general pediatric population. N. Engl. J. Med. 377, 1593–1595 (2017).

    Article  PubMed  Google Scholar 

  8. Kim, B. S., Illes, J., Kaplan, R. T., Reiss, A. & Atlas, S. W. Incidental findings on pediatric MR images of the brain. Am. J. Neuroradiol. 23, 1674–1677 (2002).

    PubMed  PubMed Central  Google Scholar 

  9. Morris, Z. et al. Incidental findings on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ 339, b3016 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  10. Morin, S. H. X. et al. Incidental findings in healthy control research subjects using whole-body MRI. Eur. J. Radio. 72, 529–533 (2009).

    Article  CAS  Google Scholar 

  11. Hegenscheid, K. et al. Potentially relevant incidental findings on research whole-body MRI in the general adult population: frequencies and management. Eur. Radio. 23, 816–826 (2013).

    Article  Google Scholar 

  12. du Preez, H., Lasker, I., Rajakulasingam, R. & Saifuddin, A. Whole-body magnetic resonance imaging: Incidental findings in paediatric and adult populations. Eur. J. Radio. 130, 109156 (2020).

    Article  Google Scholar 

  13. Ramadorai, U., Devine, J. G., Brodt, E. D. & Dettori, J. R. Incidental findings on magnetic resonance imaging of the spine in the asymptomatic pediatric population: a systematic review. Evid. Based Spine Care J. 5, 95–100 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  14. Urrutia, J., Zamora, T. & Prada, C. The prevalence of degenerative or incidental findings in the lumbar spine of pediatric patients: a study using magnetic resonance imaging as a screening tool. Eur. Spine J. 25, 596–601 (2016).

    Article  PubMed  Google Scholar 

  15. Kooijman, M. N. et al. The generation R study: design and cohort update 2017. Eur. J. Epidemiol. 31, 1234–1264. (2016).

    Article  Google Scholar 

  16. Jaddoe, V. W. V. et al. The generation R study: design and cohort update until the age of 4 years. Eur. J. Epidemiol. 23, 801–811 (2008).

    Article  PubMed  Google Scholar 

  17. Hofman, A. et al. Growth, development and health from early fetal life until young adulthood: the generation R study. Paediatr. Perinat. Epidemiol. 18, 61–72 (2004).

    Article  PubMed  Google Scholar 

  18. Jenkins, J. T. & O’Dwyer, P. J. Inguinal hernias. BMJ 336, 269–272 (2008).

    Article  PubMed  PubMed Central  Google Scholar 

  19. Cieszanowski, A., Maj, E., Kulisiewicz, P., Grudzinski, I. P. & Jakoniuk-Glodala, K. Non-contrast-enhanced whole-body magnetic resonance imaging in the general population: the incidence of abnormal findings in patients 50 years old and younger compared to older subjects. PLoS ONE 9, e107840 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  20. Boer AW, D. E. et al. Incidental findings in research: a focus group study about the perspective of the research participant. J. Magn. Reson. Imaging 47, 230–237 (2018).

    Article  PubMed  Google Scholar 

  21. Kirschen, M., Jaworska, A. & Illes, J. Subjects’ expectations in neuroimaging research. J. Magn. Reson. imaging 23, 205–209 (2006).

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

No financial assistance was received in support of the study.

Author information

Authors and Affiliations

  1. Erasmus MC, Department of Radiology, Doctor Molewaterplein 40, 3015 GD, Rotterdam, Zuid-Holland, The Netherlands

    Desirée K. de Vreede, Marjolein H. G. Dremmen, Meike W. Vernooij, Aad van der Lugt & Edwin H. G. Oei

  2. Erasmus MC, Department of Orthopedics, Doctor Molewaterplein 40, 3015 GD, Rotterdam, Zuid-Holland, The Netherlands

    Johannes H. J. M. Bessems

Authors
  1. Desirée K. de Vreede
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  4. Meike W. Vernooij
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  5. Aad van der Lugt
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  6. Edwin H. G. Oei
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Contributions

D.K.d.V., J.H.J.M.B., M.H.G.D., A.v.d.L., E.H.G.O.: substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version to be published. M.W.V.: drafting the article or revising it critically for important intellectual content; and final approval of the version to be published.

Corresponding author

Correspondence to Desirée K. de Vreede.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The Erasmus University Medical Center review board approved of the study and parents or legal guardians of the children provided written informed consent. In accordance with Dutch Law, children aged 12 years and older provided written informed consent themselves as well.

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de Vreede, D.K., Bessems, J.H.J.M., Dremmen, M.H.G. et al. The prevalence of incidental findings on pelvis MRI of 8–13-year-old children. Pediatr Res 93, 2045–2050 (2023). https://doi.org/10.1038/s41390-022-02259-6

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