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Unexpected Findings in Magnetic Resonance Enterography and their Clinical Significance


Affiliations
1 Digestive Disease Centre, Brighton and Sussex University Hospitals, Eastern Road, Brighton BN2 5BE, United Kingdom
2 Eastbourne District General Hospital, Eastbourne BN21 2UD, United Kingdom
3 Radiology Department, Eastbourne District General Hospital, Eastbourne BN21 2UD, United Kingdom
4 Gastroenterology Department, Eastbourne District General Hospital, Eastbourne BN21 2UD, United Kingdom
 

Aims: To identify the prevalence of colonic and extraenteric incidental findings in magnetic resonance enterography (MRE) and their clinical significance. Methods: We retrospectively analysed 470 MRE studies carried out between March 2012 and 2014. Incidental findings were defined as those not expected from or made apparent on the referral. MRE reports were reviewed for colonic and extraenteric findings, subcategorised into "clinically significant" and "insignificant." Follow-up was identified from the electronic patient record. Results. The majority of MRE requests were made for inflammatory bowel disease (97%). In total, 114 incidental findings were noted in 94 (20%) scans performed.There were 29 "colonic" findings (25%) with 55% having a diagnosis of colitis. Out of 85 extraenteric findings, ovarian cysts (25%), renal cysts (10%), and abdominal lymphadenopathy (9%) were the commonest.Cumulatively, 59 caseswere clinically significant (52%); of these, 30 findingswere not previously diagnosed, amounting to 26% of all incidental findings.This led to intervention in seven patients. Conclusions: Incidental findings are common in MRE and there is a substantial proportion that is clinically significant and requires further investigation.There need to be stratification of risk and employment of local guidelines in order to achieve this.
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  • Unexpected Findings in Magnetic Resonance Enterography and their Clinical Significance

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Authors

Srivathsan Ravindran
Digestive Disease Centre, Brighton and Sussex University Hospitals, Eastern Road, Brighton BN2 5BE, United Kingdom
Sarah Helen Hancox
Eastbourne District General Hospital, Eastbourne BN21 2UD, United Kingdom
Neil Barlow
Radiology Department, Eastbourne District General Hospital, Eastbourne BN21 2UD, United Kingdom
Arthur Dunk
Gastroenterology Department, Eastbourne District General Hospital, Eastbourne BN21 2UD, United Kingdom
David Howlett
Radiology Department, Eastbourne District General Hospital, Eastbourne BN21 2UD, United Kingdom

Abstract


Aims: To identify the prevalence of colonic and extraenteric incidental findings in magnetic resonance enterography (MRE) and their clinical significance. Methods: We retrospectively analysed 470 MRE studies carried out between March 2012 and 2014. Incidental findings were defined as those not expected from or made apparent on the referral. MRE reports were reviewed for colonic and extraenteric findings, subcategorised into "clinically significant" and "insignificant." Follow-up was identified from the electronic patient record. Results. The majority of MRE requests were made for inflammatory bowel disease (97%). In total, 114 incidental findings were noted in 94 (20%) scans performed.There were 29 "colonic" findings (25%) with 55% having a diagnosis of colitis. Out of 85 extraenteric findings, ovarian cysts (25%), renal cysts (10%), and abdominal lymphadenopathy (9%) were the commonest.Cumulatively, 59 caseswere clinically significant (52%); of these, 30 findingswere not previously diagnosed, amounting to 26% of all incidental findings.This led to intervention in seven patients. Conclusions: Incidental findings are common in MRE and there is a substantial proportion that is clinically significant and requires further investigation.There need to be stratification of risk and employment of local guidelines in order to achieve this.