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Incidental findings on cervical spine computed tomography scans: overlooked and unimportant?

  • Spinal Neuroradiology
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Abstract

Purpose

Imaging of the cervical spine for trauma or degenerative disease includes multiple areas of the head and neck that may harbor incidental findings. We sought to determine the incidence of common “incidentalomas” on cervical spine CT scans, their importance, and how often these lesions are mentioned in reports.

Methods

We retrospectively reviewed the cervical spine CTs and reports of all patients scanned between October 2017 and January 2018 for Tornwaldt cysts (TC), thyroglossal duct cysts and remnants (TGDC), laryngoceles (LC), pharyngoceles (PC), carotid artery calcified stenosis (CACS), and aberrant right subclavian arteries (ARSA). Descriptive statistics were performed, and the incidence of cancers (in PC and LCs) and strokes (in high-grade carotid stenosis) was assessed.

Results

Among 2116 patients, the incidences of findings were TC 6.6% (138/2100), TGDC 6.3% (122/1770), LC 9.4% (197/2100), PC 6.4% (135/2100), CACS 4.7% (100/2114), and ARSA 0.86% (18/2097). Of the 2116 patients studied, 600/2116 (28.3%) had at least one incidental finding. Only 2.9% (20/701) of incidentalomas were mentioned in the official reports.

Conclusion

Cervical incidentalomas vary in rates from ARSA (0.86%) to LC (9.4%). They are rarely mentioned in radiologists’ reports. Whether improved vigilance and reporting of these incidentalomas would benefit patient care should be explored.

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Authors and Affiliations

  1. Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, 600 N. Wolfe Street, Baltimore, MD, 21287, USA

    Elham Beheshtian, Sadaf Sahraian, David M. Yousem & Majid K. Khan

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  1. Elham Beheshtian
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  2. Sadaf Sahraian
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  3. David M. Yousem
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Correspondence to David M. Yousem.

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DY receives fees from Elsevier and consults for Medicolegal, the American College of Radiology and CMEInfo.com, outside scope and non-pertinent to this study.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Beheshtian, E., Sahraian, S., Yousem, D.M. et al. Incidental findings on cervical spine computed tomography scans: overlooked and unimportant?. Neuroradiology 60, 1175–1180 (2018). https://doi.org/10.1007/s00234-018-2080-7

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  • DOI: https://doi.org/10.1007/s00234-018-2080-7

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