Original Article

Insights into Imaging

, Volume 4, Issue 3, pp 301-308

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Extra-spinal incidental findings at lumbar spine MRI in the general population: a large cohort study

  • Carlo Cosimo QuattrocchiAffiliated withDiagnostic Imaging, Università Campus Bio-Medico di RomaRadiology, Fondazione San Raffaele Email author 
  • , Alessandro GionaAffiliated withDiagnostic Imaging, Università Campus Bio-Medico di RomaRadiology, Fondazione San Raffaele
  • , Alberto Corrado Di MartinoAffiliated withOrthopaedics and Trauma Surgery, Centre for Integrated Research (CIR), Università Campus Bio-Medico di Roma
  • , Yuri ErranteAffiliated withDiagnostic Imaging, Università Campus Bio-Medico di Roma
  • , Laura ScarciollaAffiliated withDiagnostic Imaging, Università Campus Bio-Medico di Roma
  • , Carlo Augusto MallioAffiliated withDiagnostic Imaging, Università Campus Bio-Medico di Roma
  • , Vincenzo DenaroAffiliated withOrthopaedics and Trauma Surgery, Centre for Integrated Research (CIR), Università Campus Bio-Medico di Roma
  • , Bruno Beomonte ZobelAffiliated withDiagnostic Imaging, Università Campus Bio-Medico di Roma

Abstract

Objective

To determine the prevalence of clinically and non-clinically relevant extra-spinal incidental findings (IF) in patients undergoing magnetic resonance imaging (MRI) of the lumbar spine and to evaluate the rate of undetected findings in archived radiological reports.

Methods

A retrospective search of patients undergoing lumbar spine MRI from January 2006 to December 2010 was conducted. By means of randomisation, we retrospectively reviewed 3,000 lumbar spine MRI examinations. Extra-spinal abnormalities were classified according to a modified CT Colonography Reporting and Data System (C-RADS). We retrospectively compared our structured approach with the archived MRI reports as it regarded the detection of extra-spinal IF to estimate non-detection rates.

Results

By means of the structured approach used, extra-spinal findings were detected in 2,060 (68.6 %) of the 3,000 lumbar spine MRI examinations; 362 (17.6 %) patients had indeterminate or clinically important findings (E3 and E4) requiring clinical correlation or further evaluation. After review of the original archived radiological reports, potentially important C-RADS E3 and E4 extra-spinal IF were respectively reported in 47 of the 265 (17.7 %) and in 8 of 74 (10.8 %) patients.

Conclusions

Our study shows that incidental extra-spinal findings at conventional lumbar spine MRI are common but underestimated in radiological reports.

Keywords

Lumbar spine IF Extra-spinal findings Radiological report Magnetic resonance imaging