Cross-sectional Study on Incidental Spinal Findings in Magnetic Resonance Imaging Lumbar Spine of Patients with Low Back Pain
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Abstract
Background: Incidental finding is an observation, not related to the current medical problem. Various incidental findings can be seen in the lumbar spine (LS) magnetic resonance imaging (MRI) taken for evaluation of low back pain.
Aims: To evaluate and analyze the spinal incidental findings in MRI LS of patients with low backache.
Settings and Design: A retrospective, cross-sectional analytical study.
Materials and Methods: All patients (n = 1269, males: 578, females: 691; mean age: 45 ± 15 years) with low backache, who underwent MRI of the LS at a tertiary care hospital in South India, during a period from January 2011 to August 2015.
Two radiologists evaluated these examinations for the presence of incidental findings in consensus. We included fatty vertebral hemangioma (FVH), fatty filum terminale (FFT), extraspinal synovial cyst (SC), Tarlov cyst (TC), enostosis, and limbus vertebrae.
Statistical Analysis Used: Calculated the prevalence of incidental findings and analyzed the relationship of these incidental findings with patient demographics.
Results: Overall, incidental spinal findings were present in 390 patients (30.7%). FVH was the most common incidental finding (n = 205 patients, 16.16%), followed by extraspinal SC (n = 130 patients, 10.2%), and FFT (114 patients, 9%). A pattern of increasing frequency with age noted in the FVH (P = 0.001), TC (P = 0.017), and enostosis (P = 0.008). There was no significant sex predilection for the incidental findings.
Conclusion: Incidental findings are common in LS MRI. Understanding on the nature and prevalence of these lesions is essential for the radiologist, for optimal reporting and for the clinician in appropriate interpretation of radiological reports.
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References
1. Gaudino S, Martucci M, Colantonio R, Lozupone E, Visconti E, Leone A, et al. A systematic approach to vertebral hemangioma.
Skeletal Radiol 2015;44:25‑36.
2. Ross JS, Masaryk TJ, Modic MT, Carter JR, Mapstone T, Dengel FH. Vertebral hemangiomas: MR imaging. Radiology 1987;165:165‑9.
3. Mahajan PS, Ahamad N, Mahajan AP, Al Moosawi NM. Retrospective magnetic resonance imaging evaluation of fatty filum terminale in Kuwaiti population. J Nat Sci Biol Med 2015;6:85‑8.
4. Khan AM, Girardi F. Spinal lumbar synovial cysts. Diagnosis and management challenge. Eur Spine J 2006;15:1176‑82.
5. Prashad B, Jain AK, Dhammi IK. Tarlov cyst: Case report and review of literature. Indian J Orthop 2007;41:401‑3.
6. Abdel Razek AA, Castillo M. Imaging appearance of primary bony tumors and pseudo‑tumors of the spine. J Neuroradiol 2010; 37:37‑50.
7. Koyama K, Nakazato K, Min SK, Gushiken K, Hatakeda Y, Seo K, et al. Anterior limbus vertebra and intervertebral disk degeneration in Japanese collegiate gymnasts. Orthop J Sports Med 2013;1:2325967113500222.
8. Kamath S, Jain N, Goyal N, Mansour R, Mukherjee K. Incidental findings on MRI of the spine. Clin Radiol 2009;64:353‑61.
9. Nouh MR, Eid AF. Magnetic resonance imaging of the spinal marrow: Basic understanding of the normal marrow pattern and
its variant. World J Radiol 2015;7:448‑58.
10. Rodallec MH, Feydy A, Larousserie F, Anract P, Campagna R, Babinet A, et al. Diagnostic imaging of solitary tumors of the spine:
What to do and say. Radiographics 2008;28:1019‑41.
11. Cloran FJ, Pukenas BA, Loevner LA, Aquino C, Schuster J, Mohan S. Aggressive spinal haemangiomas: Imaging correlates to clinical presentation with analysis of treatment algorithm and clinical outcomes. Br J Radiol 2015;88:20140771.
12. Doppman JL, Oldfield EH, Heiss JD. Symptomatic vertebral hemangiomas: Treatment by means of direct intralesional injection
of ethanol. Radiology 2000;214:341‑8.
13. Barzin M, Maleki I. Incidence of vertebral hemangioma on spinal magnetic resonance imaging in Northern Iran. Pak J Biol Sci
2009;12:542‑4.
14. Park HJ, Jeon YH, Rho MH, Lee EJ, Park NH, Park SI, et al. Incidental findings of the lumbar spine at MRI during herniated intervertebral disk disease evaluation. AJR Am J Roentgenol 2011;196:1151‑5.
15. Rufener SL, Ibrahim M, Raybaud CA, Parmar HA. Congenital spine and spinal cord malformations – Pictorial review. AJR Am
J Roentgenol 2010;194 3 Suppl: S26‑37.
16. Cambron S, Guerin S, Pastel D. Lumbar facet synovial cysts: Imaging characteristics and percutaneous treatment. Neurographics
2014;4:86‑92.
17. Cambron SC, McIntyre JJ, Guerin SJ, Li Z, Pastel DA. Lumbar facet joint synovial cysts: Does T2 signal intensity predict outcomes after percutaneous rupture? AJNR Am J Neuroradiol 2013;34:1661‑4.
18. Marino D, Carluccio MA, Di Donato I, Sicurelli F, Chini E, Di Toro Mammarella L, et al. Tarlov cysts: Clinical evaluation of an Italian
cohort of patients. Neurol Sci 2013;34:1679‑82.
19. Mugera C, Suh KJ, Huisman TA, Weber K, Belzberg AJ, Carrino JA, et al. Sclerotic lesions of the spine: MRI assessment. J Magn Reson Imaging 2013;38:1310‑24.
20. Huang PY, Yeh LR, Tzeng WS, Tsai MY, Shih TT, Pan HB, et al. Imaging features of posterior limbus vertebrae. Clin Imaging
2012;36:797‑802.