Spectrum of intracranial incidental findings on pediatric brain magnetic resonance imaging: What clinician should know?

Table 4 Lists three most commonly reported intracranial incidental findings on brain magnetic resonance in various pediatric-settings[5-19]

Ref.	Three most common intracranial IFs, n (%)	Comment or serious finding
Yilmaz et al[5]	White-matter hyperintensity 14 (4.3) Old infarcts 4 (1.2), and CM I 3 (0.9)	2 (0.6%) malignant tumor and 1 hydrocephalus, 0.3% IFs were relevant to headache
Bayram et al[6]	Supratentorial non-specific WMC 23 (4.4)	All patients with IFs had normal development and no seizures or head trauma
Graf et al[7]	CM I 6 (15), arachnid cysts 6 (15), brain stem parenchymal abnormality, 4 (10)	Brain stem IFs included Dandy-Walker variant, cerebellar calcification, and tectal plate hyperintensity
Schwedt et al[8]	CM I 11 (4.6), nonspecific white matter abnormalities 7 (2.9), venous angiomas and arachnoid cyst each 5 (2.5)	Discovery of 4 tumors, 4 old infarcts, 3 CM I, and 2 moyamoya required a change in management
Koirala[9]	Hippocampal sclerosis, T2 hyperintense foci in various distributions, both 4 (21) each, cortical atrophy 3 (16)	Study focus was IFs in patient with seizure. The lesions were better detected by MRI than computerized tomography
Kalnin et al[10]	Ventricular enlargement 143 (51), leukomalacia/gliosis 64 (23), heterotopias and cortical dysplasia 33 (12)	Temporal lobe lesions were detected 15%, a higher frequency than in previous studies
Gupta et al[11]	Variant signal intensity 30 (18), WMC changes 23 (13), and PVL, 10 (6)	IFs were reported in children with developmental delay as to those with normal development status
Seki et al[12]	Cavum septi pellucid 6 (15) and Pineal cyst 2 (5 ), Enlarged perivascular spaces 1 (2.5)	Focus of the study was reporting of extracranial IFs in healthy children
Gupta et al[13]	CM I and cerebellar ectopia, 16 (3.5), Arachnoid cysts, 12 (1.8)	White matter changes were the most common IFs classified under normal-variants
Potchen et al[14]	PVW matter changes/gliosis 6 (6), mild diffuse atrophy 4 (4), and Empty sella 3 (3)	Incidental findings were unassociated with age, sex, antenatal problems, or febrile seizures
Kim et al[15]	Focal white matter lesion 3 (1.3), arachnoid cyst, frontal venous angioma, and mega cisterna magna, all three 2 (0.9) each	IFs were detected on 225 conventional research in a cohort of neurologically healthy children
IFs in pediatric specialty clinics other than neurology
Oh et al[16]	Low signal intensities on T1-WI and high signal intensities on T2-WI 26 (73)	Incidence of hypointensity on T1-WI was higher in patients with Rathke’s cleft cysts
Rachmiel et al[17]	Prominent VR perivascular spaces, cerebellar ectopia, and abnormalities in sella region all 3 (7.9) each	The comparative study found no IFs association with clinical and cognitive abnormalities
Mogensen et al[19]	Arachnoid cysts 5 (9.2), of which one patient had hydrocephalus	Incidental findings were unrelated to early puberty

The study by Whitehead et al[18], 2013, which is not listed in table, because this study was limited to prevalence of pineal cysts in children, who have undergone high-resolution 3-T MRI. CM I: Chiari malformation I; WMC: White matter changes; VR: Virchow-Robin; PVL: Periventricular malacia; PVW: Periventricular white matter changes; IFs: Incidental findings; MRI: Magnetic resonance imaging.