Introduction To identify the prevalence of unexpected colonic and extra-enteric findings in magnetic resonance enterography (MRE) and determine their clinical significance.
Method We retrospectively analysed 470 MRE studies carried out between March 2012 and 2014. Unexpected findings were defined as those not expected from, or made apparent on the referral. MRE reports were reviewed for colonic and extra-enteric findings and subcategorised into ‘clinically significant’ and ‘insignificant’. ‘Significant’ findings were those that should require further investigation and management, after Consultant review. Follow up was identified from the electronic patient record.
Results The majority of MRE requests were made for inflammatory bowel disease (97%). In total, 116 unexpected findings were noted in 96 (21%) scans performed. There were 31 ‘colonic’ findings with colitis being the most frequent diagnosis (58%). Other diagnoses included diverticulosis (32%) and caecal malignancy (3%). Out of 85 extra-enteric findings, ovarian cysts (25%), renal cysts (10%) and abdominal lymphadenopathy (9%) were the commonest. Cumulatively, 61 findings were clinically significant (53%) including complex ovarian cysts, abdominal lymphadenopathy and hydronephrosis. Thirty of these findings were not previously diagnosed, amounting to 26% of all unexpected findings (see Table 1below). This led to intervention in seven patients.
Conclusion Unexpected findings are common in MRE and there is a substantial proportion that is clinically significant and requires further investigation. There needs to be a stratification of risk and employment of local guidelines in order to achieve this.
Disclosure of interest None Declared.
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