KASMEJ

Kastamonu Medical Journal regularly publishes internationally qualified issues in the field of Medicine in the light of up-to-date information.

EndNote Style
Index
Original Article
Incidental brain MRI findings in intensive care unit patients: a retrospective analysis
Aims: Magnetic resonance imaging (MRI) frequently shows unexpected results unrelated to the presumed pathology. The aim of this study is to look into the frequency and type of incidental brain MRI findings in ICU patients.
Methods: The Anesthesiology and Reanimation Intensive Care Unit at Erzincan Mengücek Gazi Training and Research Hospital was the setting for the retrospective observational study. A total of 5,145 ICU patients admitted between 2021 and 2023 were screened using the hospital information management system, eliminating those without a brain MRI. Incidental findings in brain MRI data were documented and divided into five categories: vascular (aneurysms, cavernomas, and other vascular structures), neoplastic (meningioma, pituitary mass, glioma, and other tumors), Chiari malformation, pineal cyst, and arachnoid cyst.
Results: 1317 (25.6%) participants who received brain MRI were included in the study. Incidental MRI findings were detected in 366 patients (27.8%). The most common incidental discoveries were vascular anomalies (9.79%, primarily aneurysms and cavernomas), neoplastic lesions (8.81%, primarily meningiomas and pituitary masses), arachnoid cysts (2.89%), nonspecific plaques (2.81%), pineal cysts (2.66%), and Chiari malformations (0.84%). A large majority of these patients had clinically important findings that demanded additional clinical follow-up or evaluation; nevertheless, none required emergency surgical intervention. Patients with incidental findings had a mean age of 70.92 ± 18.42 years (range 18-98).
Conclusion: In conclusion, incidental MRI results are common in critically ill patients and have significant clinical consequences. Enhanced clinician awareness and consistent management practices are critical for improving patient care, reducing unnecessary interventions, and optimizing results. Future prospective studies are required to create tailored guidelines for this population.


1. Weber F, Knopf H. Incidental findings in magnetic resonance imaging of the brains of healthy young men. J Neurol Sci. 2006;240(1-2):81-84. doi:10.1016/j.jns.2005.09.008
2. Yue NC, Longstreth WT, Jr., Elster AD, Jungreis CA, O’Leary DH, Poirier VC. Clinically serious abnormalities found incidentally at MR imaging of the brain: data from the cardiovascular health study. Radiology. 1997;202(1):41-46. doi:10.1148/radiology.202.1.8988190
3. Vernooij MW, Ikram MA, Tanghe HL, et al. Incidental findings on brain MRI in the general population. N Engl J Med. 2007;357(18):1821-1828. doi:10.1056/NEJMoa070972
4. Sunny DE, Amoo M, Al Breiki M, Teng EDW, Henry J, Javadpour M. Prevalence of incidental intracranial findings on magnetic resonance imaging: a systematic review and meta-analysis. Acta Neurochir (Wien). 2022;164(10):2751-2765. doi:10.1007/s00701-022-05225-7
5. Li Y, Thompson WK, Reuter C, et al. Rates of incidental findings in brain magnetic resonance imaging in children. JAMA Neurol. 2021;78(5):578-587. doi:10.1001/jamaneurol.2021.0306
6. Dangouloff-Ros V, Roux CJ, Boulouis G, et al. Incidental brain MRI findings in children: a systematic review and meta-analysis. AJNR Am J Neuroradiol. 2019;40(11):1818-1823. doi:10.3174/ajnr.A6281
7. Katzman GL, Dagher AP, Patronas NJ. Incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers. JAMA. 1999;282(1):36-39. doi:10.1001/jama.282.1.36
8. Bos D, Poels MM, Adams HH, et al. Prevalence, clinical management, and natural course of incidental findings on brain MR images: the population-based Rotterdam scan study. Radiology. 2016;281(2):507-515. doi:10.1148/radiol.2016160218
9. Håberg AK, Hammer TA, Kvistad KA, et al. Incidental intracranial findings and their clinical impact; the HUNT MRI study in a general population of 1006 participants between 50-66 years. PLoS One. 2016; 11(3):e0151080. doi:10.1371/journal.pone.0151080
10. Morris Z, Whiteley WN, Longstreth WT Jr., et al. Incidental findings on brain magnetic resonance imaging: systematic review and meta-analysis. Bmj. 2009;339:b3016. doi:10.1136/bmj.b3016
11. O’Sullivan JW, Muntinga T, Grigg S, Ioannidis JPA. Prevalence and outcomes of incidental imaging findings: umbrella review. BMJ. 2018; 361:k2387. doi:10.1136/bmj.k2387
12. Al-Shahi Salman R, Whiteley WN, Warlow C. Screening using whole-body magnetic resonance imaging scanning: who wants an incidentaloma? J Med Screen. 2007;14(1):2-4. doi:10.1258/096914107780154530
13. Tsushima Y, Taketomi-Takahashi A, Endo K. Prevalence of abnormal findings on brain magnetic resonance (MR) examinations in adult participants of brain docking. BMC Neurol. 2005;5:18. doi:10.1186/1471-2377-5-18 </ol> <p>
Volume 5, Issue 3, 2025
Page : 194-197
_Footer