Background  In recent years, aviation clinical medicine has undergone profound changes, and new technologies have exerted great influence on the diagnosis, prevention and evaluation of diseases of aircrew. This paper analyzes the cranial MR of aircrew during physical examination in our center in recent 10 years.

  Objective  To explore the clinical and aviation medical evaluation significance of the results of medical cranial MRI examination of aircrew.

  Methods  The data of aircrew for physical examination in Air Force Special Medical Center from April 2011 to April 2021 were selected. They were examined according to the annual general physical examination items, and head MRI, MRV and MRA were also examined. Conventional cranial MRI plain scan (T1WI, T2WI, T2FLAIR, and DWI), magnetic resonance angiography (3D-TOF-MRA), and magnetic sensitivity weighted imaging (SWI) were included, and further enhanced MRI was performed for suspicious lesions. The results were grouped into groups and corresponding suggestions were given for aviation medical evaluation.

  Results  A total of 364 aircrew were included in this study. All of them were male, aged from 22 to 46 years old (mean 30.9 years old). The normal group accounted for 83.0%; There were 2 cases of choroidal cyst and 2 cases of calcification of the falx. Imaging abnormalities with unclear clinical and aeronautical significance accounted for 8.8% , 26 cases of white matter hypersignal (WMH), 5 cases of arachnoid cyst (AC), and 1 case of empty sella (ES). Imaging abnormalities with clear clinical and aeromedical significance accounted for 7.1%, 3 cases of cerebral aneurysm (CA), 3 cases of cerebral cavernous angioma (CCA), 1 case of moyamoya disease (MMD), 1 case of venous angiomas (VA), 4 cases of hypophysoma or pituitary cystic lesions, and 14 cases of cyst in nasal sinus (CNS) or inflammation. After comprehensive analysis, 96.1% of the flight was qualified, among which 1 case of CCA was changed to bombardment arcraft, 1 case of small CA was changed to helicopter, and 1 case of huge AC was changed to UAV. Temporary flight disqualification accounted for 3.3%, 1 case with hypophysoma was unqualified for flight due to other diseases.

  Conclusion  Cranial MR is of great significance to the diagnosis and treatment of intracranial diseases for aircrew. However, some imaging changes bring great challenges to aviation medical evaluation, and its significance needs further study.