Incidental findings on MRI scans of patients presenting with audiovestibular symptoms

To determine the frequency and clinical significance of incidental findings on MRI scans of patients with audiovestibular symptoms.A retrospective analysis of 200 serial MRI scans.Gender distribution: equal. Age range: 17-82 years. One-hundred and four scans (52%) were normal and 1 scan (0.5%) demonstrated a unilateral vestibular schwannoma. Ninety-five scans (47.5%) demonstrated incidental findings. Sixty-six of these (33%) were considered of ishaemic origin and did not require further action. Five (2.5%) scans demonstrated significant findings which warranted appropriate referral; Two Gliomas (1%), 2 cases of extensive White Matter Lesions (1%), 1 lipoma (0.5%). The remaining scans demonstrated various other findings.Investigation of patients with audiovestibular symptoms with MRI scans revealed incidental findings in a significant percentage (47.5%). The majority of these findings were benign warranting no further action and only 2.5% required further referral. It is the responsibility of the referring Otolaryngologist to be aware of these findings, to be able to assess their significance, to inform the patient and if needed to refer for further evaluation.Patients frequently present to the otorhinolaryngologist with audiovestibular symptoms such as; asymmetrical hearing loss, unilateral tinnitus, sudden sensorineural hearing loss and vertigo. Investigation of these patients includes thorough clinical examination, audiological evaluation and frequently Magnetic Resonance Imaging (MRI) of the Internal Auditory Meatus (IAM), cerebellopontine angle (CPA) and brain. MRI scanning is a well-established, cost-effective investigation for these patients [1-3]. Only a small percentage of these scans reveal some form of causative pathology. However, a significant percentage will present unexpected findings which may have clinical significance. MRI findings which are unrelated to the purpose of the examination are considered incidental findings [4].A growing body of literatu