Chulalongkorn Medical Journal


P. O’Charoen


Background : Low back pain is one of the most common symptoms. Magneticresonance imaging (MRI) is the most sensitive and useful investigationin detecting and delineating spinal disease. An incidental lesion is anasymptomatic lesion found while examining a patient for an unrelatedreason.Objective : To determine frequency and majority of incidental findings in patientsundergoing MRI of lumbar spine.Method : Five hundred and ninety-seven lumbar spine MRIs in 24 months werereviewed.Results : Incidental findings were found in forty-seven cases (7.8%). There wereperineural (Tarlov) cysts 17 cases (36.2%), vertebral hemangiomas14 cases (29.8%), renal cysts 7 cases (14.9%), uterine leiomyomas5 cases (10.6%) and synovial cysts 3 cases (6.4%).Epidural lipomatosis, horseshoe kidney, dermoid cyst and cysticovarian tumor, were found one of each case (2.1%). Of these 47 patients,44 patients (93.6%) had one finding and 3 patients (6.4%) had twofindings. There is no difference between genders and age groups interm of incidence of perineural cysts, vertebral hemangiomas, renalcysts and synovial cysts and no difference in age with frequency ofuterine leiomyomas.Conclusion : The incidental lesions can be seen in MRI of lumbar spine in about 8%.The major findings show no significant difference between genders andage groups. Although most incidental lesions are asymptomatic, somemay be causes of low back pain and hence surgery may be required.Notification and careful interpretation of incidental findings on MRI oflumbar spine are necessary.


Faculty of Medicine, Chulalongkorn University

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