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

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.