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

Table 1 Indications and results of 283 MRI investigations of the small intestine

	Clinical indication for MRI	n	Total
Suspected CD	Diagnostic MRI in patients with suspected CD not confirmed at endoscopy	156	156
Known CD	Extension of newly diagnosed CD detected at endoscopy	17
	Evaluation of disease activity and extension or suspected complications of known CD	110	127
Total			283
Results of MRI- enterographies	CD in the small intestine	87	31%
	Stenosis	38	13%
	Entero-enteric fistula	4	1.4%
	Intra-abdominal abscess	2	0.7%
	Suspected IBD in the colon	35	12%

MRI: Magnetic resonance imaging; CD: Crohn’s disease; IBD: Inflammatory bowel disease.

Table 2 Previously unknown extra-intestinal findings in 58 patients

		Finding	n
E0	Female genitals	Suspected multi-cystic ovaries	1
E2	Liver	Hepatic cysts	3
		Gallstones	7
	Kidney	Renal cysts	19
		Renal anatomical variants	3
		Reduced kidney size	1
		Metallic artifact in the kidney	1
	Female genitals	Leiomyomas in the uterus	4
		Ovarian cysts	14
	Miscellaneous	Atrophy of the abdominal musculature after surgery	1
		Small amounts of free abdominal fluid	3
			56
E3	Liver	Large hepatic cyst with displacement of the right kidney	1
	Urinary tract	Bilateral nephropathy with reduced kidney size1	2
		Large bladder	2
	Female genitals	Free fluid in the pelvis and suspected leiomyoma of the uterus	1
		Two lobulated and cystic lesions in the pelvis	1
	Miscellaneous	Splenomegaly	1
		Ascites	1
		Bilateral hip joint effusion	1
		Lymphadenopathy in the mesentery	1
		Spondylosis and spinal stenosis	1
			12
E4	Focal hepatic lesion (atypical hepatic hemangioma)		1
	Unexplained mass in conjunction to the ovaries		3
	Abdominal aortic aneurysm		1
			5
Total			74

¹Both patients had a normal S-creatinine at the time of MRI-enterography with intravenous contrast.

Table 3 Previously unknown extra-intestinal findings leading to further examinations and the result of diagnostic work-up

	Extra-intestinal finding	Clinical intervention	Result of diagnostic work-up
5 true positive findings	Abdominal aortic aneurysm (E4)	CT-scan of the aorta	Abdominal aortic aneurism without rupture
	Focal hepatic lesion (E4)	Contrast-enhanced US and biopsy (atypical hemangioma)	Hemangioma
	Two unexplained masses in conjunction to the ovaries (E4)	GE and transvaginal US	Leiomyomas
		Surgery
	Free fluid in the pelvis and suspected leiomyoma of the uterus (E3)	GE and transvaginal US	Leiomyoma
	Large bladder (E3)	Transrectal US and biopsy	Prostate cancer
		Abdominal CT scan
		Biochemistry (PSA)
3 false positive findings	4.5 cm cystic lesion with an excrescens associated with the cyst wall (E4)	GE and transvaginal US	Normal
	2.9 cm solid lesion in the pelvis and displacement of the uterus (E4)	GE and transvaginal US	Normal
	Multicystic ovaries (E0)	GE and transvaginal US	Normal
Results not available	Bilateral hip joint effusion (E3)	Referred for US examination	The patient did not attend the examination

US: Ultrasound; GE: Gynecological examination; PSA: Prostate-specific antigen; CT: Computed tomography.

Table 4 Sixteen incidental findings located in the colon and their clinical impact

Finding	n	Clinical intervention	Result of diagnostic work-up
Suspected benign neoplasia (3 cm large polyp)	1	Colonoscopy and CT-colonography	Normal
Coprostasis	7	-	-
Indeterminate thickening of the cecum mucosa	2	Colonoscopy	Normal
Displacement of the cecum	3	-	-
Diverticulosis	2	-	-
Suspected malignant neoplasia	1	Colonoscopy and abdominal CT scan	Normal