Incidental findings at MRI-enterography in patients with suspected or known Crohn's disease

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Abstract

AIM: To determine the frequency and clinical impact of incidental findings detected with magnetic resonance imaging (MRI)-enterography in patients with suspected or known Crohn's disease (CD). METHODS: Incidental findings were defined as unexpected lesions outside the small intestine, not previously known or suspected at the time of referral, and not related to inflammatory bowel disease. Through a systematic review of medical charts we analyzed the clinical impact of incidental findings, and compared the MRI findings with subsequent diagnostic procedures. RESULTS: A total of 283 patients were included in the analysis, and MRI detected active CD in 31%, fistula in 1.4% and abscess in 0.7%. Extra-intestinal findings not related to CD were recorded in 72 patients (25%), of which 58 patients (20%) had 74 previously unknown lesions. Important or incompletely characterized findings were detected in 17 patients (6.0%). Incidental findings led to 12 further interventions in 9 patients (3.2%) revealing previously unknown pathological conditions in 5 (1.8%). One patient (0.4%) underwent surgery and one patient was diagnosed with a malignant disease. MRI detected incidental colonic lesions in 16 patients of which additional work-up in 4 revealed normal anatomy. Two patients (0.7%) benefitted from the additional examinations, whereas incidental findings led to unnecessary examinations in 9 (3.2%). CONCLUSION: In a minority of patients with suspected or known CD, important incidental findings are diagnosed at MRI-enterography. However, a substantial number of patients experience unnecessary morbidity because of additional examinations of benign or normal conditions.
Original languageEnglish
JournalWorld Journal of Gastroenterology
Volume16
Issue number1
Pages (from-to)76-82
Number of pages6
ISSN1007-9327
Publication statusPublished - 7. Jan 2010

Keywords

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Crohn Disease
  • Female
  • Humans
  • Incidental Findings
  • Intestines
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Unnecessary Procedures
  • Young Adult

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