上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2017, Vol. 37 ›› Issue (11): 1529-.doi: 10.3969/j.issn.1674-8115.2017.11.014

• 论著（临床研究） • 上一篇    下一篇

头颅磁共振平扫的脑外意外发现研究

姚婷婷，郁伟彬，魏小二，王丹，陆靖，李菁，李跃华   

  1. 上海交通大学附属第六人民医院放射科，上海 200233
  • 出版日期:2017-11-28 发布日期:2018-01-10
  • 通讯作者: 李跃华，电子信箱：liyuehua312@163.com
  • 作者简介:姚婷婷（1986—），女，技师，硕士；电子信箱：lyhyao@163.com
  • 基金资助:
    上海交通大学附属第六人民医院院级科学研究基金（1711）；上海市教育委员会高峰高原学科建设计划（20161427）

Study of incidental extracerebral findings on brain nonenhanced magnetic resonance imaging#br#

YAO Ting-ting, YUE Wei-bin, WEI Xiao-er, WANG Dan, LU Jing, LI Jing, LI Yue-hua   

  1. Department of Radiology, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
  • Online:2017-11-28 Published:2018-01-10
  • Supported by:
    Scientific Research Foundation of Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, 1711; Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support, 20161427

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摘要： 目的 · 探讨头颅磁共振（MRI）平扫脑外意外发现（IECFs) 的发生率和漏诊率，评估其临床价值。方法 · 回顾性分析 7 930 例 因怀疑颅内病变而行头颅 MRI 平扫的患者头颅 MRI 平扫资料，分析其 IECFs。IECFs 按临床意义分为 3 种类型：E1（无临床意义，如 鼻窦黏膜增厚），E2（临床意义可能不大，如咽部对称性增厚），E3( 有重要临床意义，如咽部非对称性增厚）。将结构式读片（从上 至下按照器官系统逐一进行读片）的结果与初始的MRI 报告结果进行比较，计算漏诊率。根据E3 类 IECFs 患者的医疗记录，评价 病变的临床意义和转归。结果 · 在 7 930 例患者中，发现 53.13% 的患者 5 992 处 IECFs，其中 E1 类占 82.2%（4 924/5 992）， E2 类占 16.6%（995/5 992）， E3 类占 1.2%（73/5 992）。 IECFs 和 E1 类的发现更常见于男性患者（P=0.000，P=0.024)。IECFs 在不同的年龄组 间比较，差异具有统计学意义（P=0.000)。IECFs 总的漏诊率为 56.9%（3 409/5 992）； E3 类 IECFs 的漏诊率为 32.9%（24/73）。 73 例 E3 类 IECFs 患者中，34 例（46.6%）患者在研究期间接受最终诊断和适当治疗。结论 · 在头颅 MRI 检查的患者中，IECFs 普遍存在， 近 1/3 的 E3 类 IECFs 可能会漏诊；根据临床价值对 IECFs 进行分级报告，有助于患者的诊治，减少漏诊。

关键词:  意外发现, 脑, 磁共振成像, 发生率

Abstract:

Objective · To explore the frequency, nondetection rate, and clinical importance of incidental extracerebral findings (IECFs)on brain nonenhanced magnetic resonance imaging(MRI).  Methods · The MRI data of  7 930 cases with suspected intracerebral lesionin were retrospectively analyzed. IECFs were categorized as E1 (clinically unimportant, e.g., sinus mucosal thickening), E2 (likely unimportant, e.g.,pharyngeal mucosal symmetrical thickening), and E3 (potentially important, e.g., pharyngeal mucosal asymmetrical thickening). The nondetection rate was determined by comparing the results of the structured approach with the initial MRI reports. The medical records were examined for patients with E3 IECFs to assess clinical importance and outcome of these lesions.  Results · A total of 5 992 IECFs were found in 4 213 patients (53.13%, 4 213/7 930). IECFs with E1 was 82.2% (4 924/5 992), E2 was 16.6% (995/5 992) and E3 1.2% (73/5 992). Overall IECFs and E1 findings were occurred more commonly in male patients (P=0.000, P=0.024). And the statistically significant difference was also found among different age groups (P=0.000). The nondetection rate was 56.9% (3 409/5 992) for overall IECFs and 32.9% (24/73) for E3 IECFs. Of the 73 patients with E3 IECFs, 34 (46.6%) received final diagnosis and appropriate treatment during the study period.  Conclusion · IECFs are prevalent in clinical patients on brain MRI with a nondetection rate of 32.9% for potentially important (E3) findings. The reporting of IECFs according to clinical importance is helpful for patients’ management.

Key words:  incidental findings, cerebral, magnetic resonance imaging, incidence

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