Brain infarcts are the most frequently identified incidental finding on a brain MRI, with aneurysms and benign primary tumors second and third these findings are discovered incidentally, meaning they are discovered when a patient undergoes imaging of the brain for a different reason and are not the cause of any presenting symptoms.
The most common findings on a brain MRI have a high dependence on the population being considered and the context with which the MRI is performed (i.e., clinical symptoms, research, screening). Nevertheless, with respect to the general adult population (particularly in research and screening studies), incidental brain abnormalities consistent with aging and cerebrovascular disease are most frequently observed.
Clinical Importance
The most commonly noted incidental findings in these studies are white matter hyperintensities and cerebral infarcts that are asymptomatic White matter changes due to aging can be found in more than half of older adults having a brain MRI; when seen with other findings, they are considered generally a part of the aging process, although they might identify the presence of cerebrovascular disease.
White matter changes can be categorized by location: periventricular and deep white matter also called subcortical white matter. periventricular locations are usually considered non-vascular in nature while changes in the deep white matter or subcortical white matter are usually considered to be vascular.
Asymptomatic brain infarcts, especially lacunar infarcts, affect approximately of people aged While patients may not present with symptoms of stroke, their presence is an indicator of cerebrovascular disease and is associated with approximately a twofold increase in the risk of subsequent stroke and future cognitive dysfunction.
Large-Scale Studies & Management
Large-scale studies of brain MRI findings in research volunteers have demonstrated that essentially all scans are normal or show minor, non-significant, variations from normal. For example, in one study of consecutive brain MRI examinations were normal, had abnormal findings that did not require any follow up, and only had previously interpreted findings that warranted recommendations for follow up.
The most commonly observed abnormal findings in this cohort was vascular disease, followed by neoplastic and congenital lesions.
Clinical Implications
Change in white matter and small infarcts are frequent and usually benign in elderly patients but, because of their presence, the patient is at risk for either a stroke or for progressing cognitive decline, which may justify further investigation or management of vascular risk factors.
The incidental discovery of meningioma, for instance, might be watched or treated actively if it grows or causes symptoms, but a lot of them we can just leave alone.
Cerebrovascular ischemic alterations and microhemorrhages
Brain parenchymal alterations secondary to cerebrovascular disease asymptomatic or silent brain infarct, age-related white matter changes, and microhemorrhages are frequent incidental findings in brain MRI, and often encountered in the elderly. Most are lacunar infarcts.
Though patients with lack overt stroke symptoms, they should be regarded as a marker of cerebrovascular disease, not an incidental condition.
Multinodular and vacuolating neuronal tumor
Multinodular and vacuolating neuronal tumor is a newly established benign neural and glial tumor of the central nervous system initially characterized by Huse et al. in It was introduced into the WHO Classification of CNS Tumors in for the first time. MVNT can be symptomatic in patients, or it can be incidentally identified on MRI. Most frequent clinical presentations are headaches and seizures. Incidental prevalence of MVNT is still unknown. The most frequent site is within the supratentorial brain with a predilection for subcortical white matter and overlying cortex.
On MRI, MVNT typically appears as a group of diminutive, “bubbly” T1 hypointense and T2 hyperintense, non-enhancing lesions centered in the subcortical white matter and occasionally extending to involve the overlying cortical gray matter . Affected gyri and cortices otherwise may appear normal.
Epidermoid cyst
The majority of epidermoid cysts are clinically silent but occasionally present with symptoms from local mass effect. The incidence of incident epidermoid cyst on brain MRI is They are usually located in basal cisterns, with the most frequent being cerebellopontine angle cistern. They can, on occasion, occur in the brain parenchyma or within the bones.
Though unusual, malignant change of epidermoid cysts and aseptic meningitis secondary to cyst rupture have occurred.
Conclusion
Incidental MRI brain findings in patients who undergo imaging are not rare. Parenchymal changes of the brain due to cerebrovascular disease and intracranial tumors, more commonly meningiomas, are age dependent, and their incidence rises in elderly individuals.
Frequently Asked Questions
Q. What are the most common brain MRI findings?
The most typical discoveries in brain MRI tend to be cerebrovascular disease-related changes, including age-related white matter changes, microhemorrhages, and silent brain infarcts, particularly in elderly populations.
Q. What are the normal findings of the brain MRI
A normal brain MRI would normally show symmetrical brain anatomy without any shape or size abnormalities, well-differentiated cerebrospinal fluid spaces, and normal signal patterns for the brain.
Q. What can be found in an MRI of the brain?
A brain MRI will show a range of conditions and abnormalities such as tumors, stroke, multiple sclerosis, brain trauma, and developmental anomalies.
Q. What are normal MRI results?
A normal brain MRI usually will reveal normal appearance and intensity of the parenchyma of the brain, normal ventricular and cisternal spaces, absence of lesions and vascular abnormalities, and normal orbits, sinuses, and skull.
Q. How to find the best imaging centre near me in Delhi NCR?
You can just type the best imaging centre near me on Google or directly contact carebox for consultation.
