Incidental findings in magnetic resonance imaging of the brains of healthy young men,☆☆

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Abstract

Background and purpose

To determine the frequency of serious intracranial abnormalities in a healthy young male population.

Methods

Cranial MRI of 2 536 healthy young males, mean age 20.5 years, all applicants for military flying duties in the German Air Force.

Results

The authors report a variety of morphological abnormalities in the brains of a large population of healthy young males, providing data on disease prevalence. Arachnoid cysts were found in 1.7% (95% CI 1.2 to 2.3%), vascular abnormalities in 0.51% (95% CI 0.29 to 0.9%), and intracranial tumors in 0.47% (95% CI 0.26 to 0.85%) of the applicants. No cerebral aneurysms were found.

Conclusion

The prevalence of primary brain tumors seems to be higher, whereas the prevalence of intracranial aneurysms is lower than expected. Only a small percentage of the detected abnormalities require urgent medical attention.

Introduction

Magnetic resonance imaging (MRI) occasionally discloses unexpected abnormalities, usually in the setting of an investigation for some other reason. In such cases, the relevance of the abnormal finding must be determined, considering the impact on the patient. It must be decided if the abnormality is a simple variation of the norm or whether it is clinically serious. Most of the studies reporting on the prevalence of such incidental findings use MRI studies that have been performed to examine patients for any kind of disorder [1]. Studies were rarely performed on healthy subjects [2], [3], [4]. However, studies on healthy subjects could provide unbiased data to estimate the prevalence of certain conditions, thus serving as a baseline and as a reference for further epidemiological studies.

The present study was carried out to determine the frequency of serious intracranial abnormalities in a healthy young male population.

Section snippets

Study population

Participants of this study are all applicants for military flying duties who were examined in the division of clinical aviation medicine of the German Air Force Institute of Aviation Medicine in the time between 01/01/2000 and 06/30/2004. In principle, every applicant for military flying duties undergoes cranial MRI screening in order to rule out intracranial abnormalities that may be hazardous for aviation safety. In their initial flight physical which is supposed to determine the “medical

Results

2536 subjects were screened for the purpose of this study. All subjects were males in a mean age of 20.5 years (ranging between 17 and 35 years). The results of the MRI screening are presented in Table 1 (normal findings and variations of the norm) and in Table 2 (abnormal findings). The normal or abnormal classification is arbitrary in some categories, since it is up to the investigator's discretion, if very few white matter lesions in a healthy person or falx ossifications or intracranial

Discussion

The present study describes the prevalence of incidental findings in MRIs of the brain in a large cohort of males who were specifically chosen for healthiness. It may thus serve as a reference or as a baseline for further epidemiological studies. Our population is selected under the following conditions: young men who voluntarily apply for military flying service, with normal general medical and neurological findings, and who have passed a psychological examination, when their occupational

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Disclaimer: The opinions in this study represent the opinions of the authors and are not necessarily those of the German Air Force Surgeon General or those of the Federal Ministry of Defense.

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Disclosure: The authors have no financial or competing interests to disclose.

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