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首页> 外文期刊>The Internet Journal of Neurology >Brain screening versus colon screening: Are We Dealing With The Same Issues?
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Brain screening versus colon screening: Are We Dealing With The Same Issues?

机译：脑部筛查与结肠筛查：我们是否处理相同的问题？

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Dear Sir, We too read with interest the study by Vernooij et al published recently in the New England Journal of Medicine to determine the incidence of incidental findings on brain MRI in the general population 1and the article in response to the above study by Illes published in Lancet Neurology 2. The subjects were 2000 persons (mean age, 63.3 years; range, 45.7 to 96.7) in whom 1.5 T brain MRI was performed according to a standardized protocol. Two experienced neuroradiologists reviewed all incidental findings found on imaging. Unexpected asymptomatic brain abnormalities like silent brain infarcts (7.2%), benign brain tumors (1.6%) like meningiomas and cerebral aneurysms (1.8%) were detected. The authors make the argument that these incidental abnormalities may be potentially clinically relevant and aid appropriate intervention at an earlier stage of the pathological process. While the use of imaging tests to screen for brain pathologies seems attractive it has the potential for generating data that the physician does not know how to interpret. What does one advice a healthy individual who is noted to cerebral atrophy on imaging? We still have no scientific answers to his frightened questions of would he develop dementia? If so when? What if he demands an intervention for which there is no medical justification like a brain biopsy to confirm the diagnosis. We agree with Illes that until we have better understanding of the natural history of silent brain infarcts, benign brain tumors like meningiomas and vascular lesions like aneurysms, brain screening of asymptomatic individuals has the potential of compelling both the individual and his physician to do something. Certainly screening the brain is unlike screening the colon and the adage if it is not broken do not fix it may indeed hold true.;Correspondence to NK Sethi, MDDepartment of NeurologyNYP-Weill Cornell Medical Center525 East, 68th StreetNew York, NY 10021(U.S.A.)E-mail: sethinitinmd@hotmail.com
机译：亲爱的主席先生，我们也很感兴趣地阅读了Vernooij等人最近发表在《新英格兰医学杂志》上的研究，以确定普通人群中脑MRI偶然发现的发生率1，并且该文章针对Illes于2000年发表的上述研究做出了回应柳叶刀神经病学2.受试者为2000人（平均年龄63.3岁;范围45.7至96.7），其中根据标准化方案进行了1.5 T脑MRI检查。两位经验丰富的神经放射科医生回顾了影像学上发现的所有偶然发现。发现了意外的无症状脑异常，如无声脑梗塞（7.2％），良性脑肿瘤（1.6％），如脑膜瘤和脑动脉瘤（1.8％）。作者提出这些偶然异常可能与临床相关，并有助于在病理过程的早期进行适当的干预。尽管使用影像学检查筛查脑部疾病似乎很有吸引力，但它具有产生医师不知道如何解释的数据的潜力。一个健康的个体在影像学上注意到脑萎缩有什么建议？对于他会发展为痴呆症的恐惧问题，我们仍然没有科学的答案。如果是，什么时候？如果他需要没有医学证据如脑活检来证实诊断的干预措施，该怎么办。我们同意Illes的观点，即在我们对静默性脑梗塞，良性脑肿瘤（如脑膜瘤）和血管病变（如动脉瘤）的自然病史有了更好的了解之前，对无症状个体进行脑部筛查有可能迫使该个体及其医师做某事。当然，筛查大脑不同于筛查结肠，如果它没有破裂就不能固定它的话，那格言的确可能成立。电子邮件：sethinitinmd@hotmail.com

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