Klein, Andrew P.Tetzlaff, Julie E.Bonis, Joshua M.Nelson, Lindsay D.Mayer, Andrew R.Huber, Daniel L.Harezlak, JaroslawMathews, Vincent P.Ulmer, John L.Sinson, Grant P.Nencka, Andrew S.Koch, Kevin M.Wu, Yu-ChienSaykin, Andrew J.DiFiori, John P.Giza, Christopher C.Goldman, JoshuaGuskiewicz, Kevin M.Mihalik, Jason P.Duma, Stefan M.Rowson, StevenBrooks, AlisonBroglio, Steven P.McAllister, ThomasMcCrea, Michael A.Meier, Timothy B.2020-11-032020-11-032019-05-22Klein, A. P., Tetzlaff, J. E., Bonis, J. M., Nelson, L. D., Mayer, A. R., Huber, D. L., Harezlak, J., Mathews, V. P., Ulmer, J. L., Sinson, G. P., Nencka, A. S., Koch, K. M., Wu, Y.-C., Saykin, A. J., DiFiori, J. P., Giza, C. C., Goldman, J., Guskiewicz, K. M., Mihalik, J. P., … Meier, T. B. (2019). Prevalence of Potentially Clinically Significant Magnetic Resonance Imaging Findings in Athletes with and without Sport-Related Concussion. Journal of Neurotrauma, 36(11), 1776–1785. https://doi.org/10.1089/neu.2018.60550897-7151https://hdl.handle.net/1805/24256Previous studies have shown that mild traumatic brain injury (mTBI) can cause abnormalities in clinically relevant magnetic resonance imaging (MRI) sequences. No large-scale study, however, has prospectively assessed this in athletes with sport-related concussion (SRC). The aim of the current study was to characterize and compare the prevalence of acute, trauma-related MRI findings and clinically significant, non-specific MRI findings in athletes with and without SRC. College and high-school athletes were prospectively enrolled and participated in scanning sessions between January 2015 through August 2017. Concussed contact sport athletes (n = 138; 14 female [F]; 19.5 ± 1.6 years) completed up to four scanning sessions after SRC. Non-concussed contact (n = 135; 15 F; 19.7 ± 1.6) and non-contact athletes (n = 96; 15 F; 20.0 ± 1.7) completed similar scanning sessions and served as controls. Board-certified neuroradiologists, blinded to SRC status, reviewed T1-weighted and T2-weighted fluid-attenuated inversion recovery and T2*-weighted and T2-weighted images for acute (i.e., injury-related) or non-acute findings that prompted recommendation for clinical follow-up. Concussed athletes were more likely to have MRI findings relative to contact (30.4% vs. 15.6%; odds ratio [OR] = 2.32; p = 0.01) and non-contact control athletes (19.8%; OR = 2.11; p = 0.04). Female athletes were more likely to have MRI findings than males (43.2% vs. 19.4%; OR = 2.62; p = 0.01). One athlete with SRC had an acute, injury-related finding; group differences were largely driven by increased rate of non-specific white matter hyperintensities in concussed athletes. This prospective, large-scale study demonstrates that <1% of SRCs are associated with acute injury findings on qualitative structural MRI, providing empirical support for clinical guidelines that do not recommend use of MRI after SRC.en-USconcussionMRImTBIsportwhite matter hyperintensityArticle