Finding more than what you are looking for: a retrospective study of incidental findings in magnetic resonance imaging (MRI) scans performed for patients suspicious of vestibular schwannoma

Abstract

Background: Nearly 20% of the patients presenting to ENT department with audiovestibular symptoms are considered potential candidates for vestibular schwannoma screening. MRI scan done on these patients can also detect a large number of incidental findings. We did a retrospective descriptive study of incidental findings identified on MRI scans done on patients presenting to the ENT department in a county hospital in United Kingdom from April 2020 to April 2021. All MRI reports were scrutinised and various incidental findings tabulated. The further management of patients with these findings were also analysed. Results: A total of 159 MRIs were reviewed. The most common incidental finding was small vessel disease followed by old infarcts. Fifteen patients were found to have significant incidental findings. The detection rate of vestibular schwannoma was 3.1%. Conclusion: With the increased use of imaging technology, the incidence of incidental findings has risen. Understanding the significance of these findings is important so that clinicians can counsel their patients and make appropriate management plans. Categorising the incidental findings into groups based on their level of significance may help in making these clinical decisions.