Skip to main content
SpringerLink
Log in

Prevalence and clinical significance of incidental extra-intestinal findings in MR enterography: experience of a single University Centre

  • ABDOMINAL RADIOLOGY
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

To determine the incidence and clinical relevance of extra-intestinal incidental findings (IF) in a cohort of patients with proven or suspected Crohn disease (CD) examined with magnetic resonance enterography (MR-E) in a single University Centre.

Methods

Between January 2018 and June 2019, 182 patients with proven or suspected CD with a planned first MR-E examination, were retrospectively included in this study. Incidental findings were considered as any abnormality identified in the absence of previous clinically suspected or known disease. IF were categorized as unremarkable, benign or potentially relevant findings requiring further imaging or specific treatment.

Results

Of the 182 revised MR-E, extra-intestinal IF were recorded in 70 cases (38.5%); 35 (50%) incidental lesions were recognized as non-significant, 24 (34%) as benign and 11 (16%) as clinically relevant. Moreover, there was a positive correlation between IF and patients’ age (p < 0.0001).

Conclusions

In our experience, a high number of IF (38.5%) was found, with a prevalence that increases with patients’ age. Clinically relevant findings were found in 16% of MR-E. This means that MR-E is a useful tool to detect IF, therefore, the presence of a radiologist during the image acquisition is crucial in adding sequences to the examination.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kim SH (2015) Computed tomography enterography and magnetic resonance enterography in the diagnosis of Crohn’s disease. Intest Res 13(1):27–38. https://doi.org/10.5217/ir.2015.13.1.27

    Article  PubMed  PubMed Central  Google Scholar 

  2. Masselli G, Casciani E, Polettini E, Gualdi G (2008) Comparison of MR enteroclysis with MR enterography and conventional enteroclysis in patients with Crohn’s disease. Eur Radiol 18(3):438–447. https://doi.org/10.1007/s00330-007-0763-2

    Article  PubMed  Google Scholar 

  3. Laghi A, Borrelli O, Paolantonio P, Dito L, Buena de Mesquita M, Falconieri P, Passariello R, Cucchiara S (2003) Contrast enhanced magnetic resonance imaging of the terminal ileum in children with Crohn’s disease. Gut 52(3):393–397

    Article  CAS  Google Scholar 

  4. Ognibene NM, Basile M, Di Maurizio M, Petrillo G, De Filippi C (2016) Features and perspectives of MR enterography for pediatric Crohn disease assessment. Radiol Med 121(5):362–377. https://doi.org/10.1007/s11547-015-0613-2

    Article  PubMed  Google Scholar 

  5. Macarini L, Stoppino LP, Centola A, Muscarella S, Fortunato F, Coppolino F, Della Valle N, Ierardi V, Milillo P, Vinci R (2013) Assessment of activity of Crohn’s disease of the ileum and large bowel: proposal for a new multiparameter MR enterography score. Radiol Med 118(2):181–195. https://doi.org/10.1007/s11547-012-0841-7

    Article  CAS  PubMed  Google Scholar 

  6. Tolan DJ, Greenhalgh R, Zealley IA, Halligan S, Taylor SA (2010) MR enterographic manifestations of small bowel Crohn disease. Radiographics 30(2):367–384

    Article  Google Scholar 

  7. Scardapane A, Ambrosi A, Salinaro E, Mancini ME, Principi M, Di Leo A, Lorusso F, Stabile Ianora AA, Angelelli G (2015) Assessment of disease activity in small Bowel Crohn’s disease: comparison between endoscopy and magnetic resonance enterography using MRIA and modified MRIA score. Gastroenterol Res Pract 2015:1–7. https://doi.org/10.1155/2015/159641

    Article  Google Scholar 

  8. Fujii T, Naganuma M, Kitazume Y, Saito E, Nagahori M, Ohtsuka K, Watanabe M (2014) Advancing magnetic resonance imaging in Crohn’s disease. Digestion 89(1):24–30. https://doi.org/10.1159/000356210

    Article  PubMed  Google Scholar 

  9. Athanasakos A, Mazioti A, Economopoulos N, Kontopoulou C, Stathis G, Filippiadis D, Spyridopoulos T, Alexopoulou E (2015) Inflammatory bowel disease-the role of cross-sectional imaging techniques in the investigation of the small bowel. Insights Imaging 6(1):73–83. https://doi.org/10.1007/s13244-014-0377-6

    Article  PubMed  Google Scholar 

  10. Jensen MD, Nathan T, Kjeldsen J, Rafaelsen SR (2010) Incidental findings at MRI-enterography in patients with suspected or known Crohn’s disease. World J Gastroenterol 16(1):76–82

    PubMed  PubMed Central  Google Scholar 

  11. Herfarth HH, Grunert M, Klebl F, Strauch U, Feuerbach S, Scholmerich J, Rogler G, Schreyer AG (2009) Frequency and nature of incidental extra-enteric lesions found on magnetic resonance enterography (MR-E) in patients with inflammatory bowel diseases (IBD). PLoS ONE 4(4):e4863. https://doi.org/10.1371/journal.pone.0004863

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Machaalany J, Yam Y, Ruddy TD, Abraham A, Chen L, Beanlands RS, Chow BJ (2009) Potential clinical and economic consequences of noncardiac incidental findings on cardiac computed tomography. J Am Coll Cardiol 54(16):1533–1541. https://doi.org/10.1016/j.jacc.2009.06.026

    Article  PubMed  Google Scholar 

  13. Stone JH (2006) Incidentalomas–clinical correlation and translational science required. N Engl J Med 354(26):2748–2749. https://doi.org/10.1056/NEJMp058264

    Article  CAS  PubMed  Google Scholar 

  14. Patel MD, Ascher SM, Paspulati RM, Shanbhogue AK, Siegelman ES, Stein MW, Berland LL (2013) Managing incidental findings on abdominal and pelvic CT and MRI, part 1: white paper of the ACR Incidental Findings Committee II on adnexal findings. J Am Coll Radiol 10(9):675–681. https://doi.org/10.1016/j.jacr.2013.05.023

    Article  PubMed  Google Scholar 

  15. Khosa F, Krinsky G, Macari M, Yucel EK, Berland LL (2013) Managing incidental findings on abdominal and pelvic CT and MRI, Part 2: white paper of the ACR Incidental Findings Committee II on vascular findings. J Am Coll Radiol 10(10):789–794. https://doi.org/10.1016/j.jacr.2013.05.021

    Article  PubMed  Google Scholar 

  16. Heller MT, Harisinghani M, Neitlich JD, Yeghiayan P, Berland LL (2013) Managing incidental findings on abdominal and pelvic CT and MRI, part 3: white paper of the ACR Incidental Findings Committee II on splenic and nodal findings. J Am Coll Radiol 10(11):833–839. https://doi.org/10.1016/j.jacr.2013.05.020

    Article  PubMed  Google Scholar 

  17. Sebastian S, Araujo C, Neitlich JD, Berland LL (2013) Managing incidental findings on abdominal and pelvic CT and MRI, Part 4: white paper of the ACR Incidental Findings Committee II on gallbladder and biliary findings. J Am Coll Radiol 10(12):953–956. https://doi.org/10.1016/j.jacr.2013.05.022

    Article  PubMed  Google Scholar 

  18. Berland LL (2013) Overview of white papers of the ACR incidental findings committee ii on adnexal, vascular, splenic, nodal, gallbladder, and biliary findings. J Am Coll Radiol 10(9):672–674. https://doi.org/10.1016/j.jacr.2013.05.012

    Article  PubMed  Google Scholar 

  19. Parker LS (2008) The future of incidental findings: should they be viewed as benefits. J Law Med Ethics 36(2):341–351. https://doi.org/10.1111/j.1748-720x.2008.00278.x

    Article  PubMed  PubMed Central  Google Scholar 

  20. Reiner BI (2009) The challenges, opportunities, and imperative of structured reporting in medical imaging. J Digit Imaging 22(6):562–568. https://doi.org/10.1007/s10278-009-9239-z

    Article  PubMed  PubMed Central  Google Scholar 

  21. Berland LL, Silverman SG, Gore RM, Mayo-Smith WW, Megibow AJ, Yee J, Brink JA, Baker ME, Federle MP, Foley WD, Francis IR, Herts BR, Israel GM, Krinsky G, Platt JF, Shuman WP, Taylor AJ (2010) Managing incidental findings on abdominal CT: white paper of the ACR incidental findings committee. J Am Coll Radiol 7(10):754–773. https://doi.org/10.1016/j.jacr.2010.06.013

    Article  PubMed  Google Scholar 

  22. Hellstrom M, Svensson MH, Lasson A (2004) Extracolonic and incidental findings on CT colonography (virtual colonoscopy). AJR Am J Roentgenol 182(3):631–638. https://doi.org/10.2214/ajr.182.3.1820631

    Article  PubMed  Google Scholar 

  23. Hassan C, Pickhardt PJ, Laghi A, Kim DH, Zullo A, Iafrate F, Di Giulio L, Morini S (2008) Computed tomographic colonography to screen for colorectal cancer, extracolonic cancer, and aortic aneurysm: model simulation with cost-effectiveness analysis. Arch Intern Med 168(7):696–705. https://doi.org/10.1001/archinte.168.7.696

    Article  PubMed  Google Scholar 

  24. Hara AK, Johnson CD, MacCarty RL, Welch TJ (2000) Incidental extracolonic findings at CT colonography. Radiology 215(2):353–357. https://doi.org/10.1148/radiology.215.2.r00ap33353

    Article  CAS  PubMed  Google Scholar 

  25. Zhang XM, Mitchell DG, Dohke M, Holland GA, Parker L (2002) Pancreatic cysts: depiction on single-shot fast spin-echo MR images. Radiology 223(2):547–553. https://doi.org/10.1148/radiol.2232010815

    Article  PubMed  Google Scholar 

  26. Tanaka M, Fernandez-del Castillo C, Adsay V, Chari S, Falconi M, Jang JY, Kimura W, Levy P, Pitman MB, Schmidt CM, Shimizu M, Wolfgang CL, Yamaguchi K, Yamao K (2012) International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology 12(3):183–197. https://doi.org/10.1016/j.pan.2012.04.004

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, “Di Venere” Hospital of Bari, Bari, Italy

    Filomenamila Lorusso

  2. Section of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari “Aldo Moro”, Bari, Italy

    Mariabeatrice Principi

  3. Section of Diagnostic Imaging, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare, 11, 70123, Bari, Italy

    Pasquale Pedote, Pasquale Pignataro, Mariantonietta Francavilla & Arnaldo Scardapane

  4. Section of Radiation Therapy, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, Bari, Italy

    Angela Sardaro

Authors
  1. Filomenamila Lorusso
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mariabeatrice Principi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pasquale Pedote
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pasquale Pignataro
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mariantonietta Francavilla
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Angela Sardaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Arnaldo Scardapane
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Arnaldo Scardapane.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The Local ethical committee was informed and approved this retrospective study.

Informed consent

An informed consent was signed by all the patients regarding the possible use of their data for retrospective studies.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lorusso, F., Principi, M., Pedote, P. et al. Prevalence and clinical significance of incidental extra-intestinal findings in MR enterography: experience of a single University Centre. Radiol med 126, 181–188 (2021). https://doi.org/10.1007/s11547-020-01235-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11547-020-01235-6

Keywords

Search

Navigation