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

Lorusso, Filomenamila; Principi, Mariabeatrice; Pedote, Pasquale; Pignataro, Patrizia; Francavilla, Mariantonietta; Sardaro, Angela; Scardapane, Arnaldo

doi:10.1007/s11547-020-01235-6

Cited by 7 publications

(6 citation statements)

References 25 publications

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“…Extraintestinal incidental findings were observed in nearly 20-40% of MRE scans, and approximately 20-50% of these findings were clinically significant [ 20 , 21 ]. Hepatic complications comprise the majority of extraintestinal findings [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…In a review of 459 MRE scans, ovarian cysts followed by renal cysts were the most common extraintestinal incidental findings [ 21 ]. In a recent investigation, hepatic angioma, hepatic cyst, gallstones, and splenomegaly were observed in 25%, 20%, 14.3%, and 4.2% of cases, respectively, on MRE scans [ 20 ]. The findings that can be potentially associated with PSC might have been underestimated in MRE examinations.…”

Section: Discussionmentioning

confidence: 99%

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The clinical significance of biliary findings in magnetic resonance enterography of patients with inflammatory bowel disease

et al. 2022

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Purpose: Given the association of inflammatory bowel disease (IBD) and primary sclerosing cholangitis (PSC), we aimed to investigate the clinical relevance of abnormal hepatobiliary findings on magnetic resonance enterography (MRE) of IBD patients considering the risk of over-or underestimation of PSC at MRE. Material and methods:Using the MRE dataset of patients referring to a tertiary hospital and the National Registry of Crohn's and Colitis, 69 MREs, including 23 IBD-PSC, 23 IBD-without PSC, and 23 healthy controls (HC), were retrospectively reviewed by 2 experienced radiologists blinded to the clinical data, to evaluate hepatobiliary abnormalities. Sensitivity, specificity, and likelihood ratios were calculated.Results: Bile duct irregularities were the most common finding in the IBD-PSC group, with a frequency of 91%.Intra-and extrahepatic bile duct (IHBD and EHBD) irregularities were observed in 87% and 78% of PSC patients, respectively. Higher frequency of IHBD and EHBD wall thickening, bile duct dilation, EHBD stricture, and periportal oedema were observed in the IBD-PSC group. Peribiliary T2-weighted hyperintensities and contrast-enhancement were significantly more common in the IBD-PSC group than in the IBD and HC groups (48% and 35%, respectively) (p < 0.001). Detection of biliary irregularities on MRE had a specificity of 94% (95% CI: 82-99%), a sensitivity of 91% (95% CI: 72-99%), and a positive likelihood ratio of 14.0 (95% CI: 4.7-42.1) for the diagnosis of PSC. Conclusions:This study emphasizes the importance of assessing and reporting hepatobiliary abnormalities visible in the MRE of patients with IBD to avoid a delayed diagnosis of PSC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The clinical significance of biliary findings in magnetic resonance enterography of patients with inflammatory bowel disease

et al. 2022

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“…In recent years, there has been increasing use of MRI imaging for the study of bowel and gastrointestinal pathology [39,[106][107][108][109][110][111][112]. From the available studies, it has emerged that MRI may allow for the identification of pathological findings of acute IC and their correlation with histopathological features [28,29,90,113].…”

Section: Mri Imaging Techniquementioning

confidence: 99%

Large Bowel Ischemia/Infarction: How to Recognize It and Make Differential Diagnosis? A Review

Iacobellis

Narese

Berritto³

et al. 2021

Diagnostics

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Ischemic colitis represents the most frequent form of intestinal ischemia occurring when there is an acute impairment or chronic reduction in the colonic blood supply, resulting in mucosal ulceration, inflammation, hemorrhage and ischemic necrosis of variable severity. The clinical presentation is variable and nonspecific, so it is often misdiagnosed. The most common etiology is hypoperfusion, almost always associated with generalized atherosclerotic disease. The severity ranges from localized and transient ischemia to transmural necrosis of the bowel wall, becoming a surgical emergency, with significant associated morbidity and mortality. The diagnosis is based on clinical, laboratory suspicion and radiological, endoscopic and histopathological findings. Among the radiological tests, enhanced-CT is the diagnostic investigation of choice. It allows us to make the diagnosis in an appropriate clinical setting, and to define the entity of the ischemia. MR may be adopted in the follow-up in patients with iodine allergy or renal dysfunctions, or younger patients who should avoid radiological exposure. In the majority of cases, supportive therapy is the only required treatment. In this article we review the pathophysiology and the imaging findings of ischemic colitis.

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“…Although less common than other incidentalomas, such as those in the liver or kidney, occasionallydetected spleen abnormalities in asymptomatic subjects are nowadays encountered with an increased frequency [1][2][3]. This is due, on one hand, to the widespread use, and overuse, of abdominal or whole-body imaging examinations, and, on the other hand, to the increased sensitivity of the current imaging modalities, including X-rays, ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) [2,[4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Incidental Focal Spleen Lesions: Integrated Imaging and Pattern Recognition Approach to the Differential Diagnosis

Corvino,

Granata,

Tafuri

et al. 2023

Diagnostics

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Spleen lesions and pseudolesions, detected incidentally in imaging, are not uncommon and may require further work-up. The imaging appearance of focal splenic lesions (FSLs) may not be pathognomonic, because of considerably overlapping features. Consequently, all imaging techniques lack specificity to fully characterize FSLs. Clinical correlation is mandatory, so as, first of all, to categorize the patient as having or not having a history of solid or hematologic malignancy. Nowadays, many patients have old imaging studies available for comparison and, consequently, it is important to understand if the lesion was previously present or not, and if the size is the same or has changed. In the absence of comparison studies, and with a lack of imaging features of benignity, further investigation may be necessary, using PET, biopsy, or short-term follow-up. Some algorithms have been proposed to manage incidental FSLs; however, none of these strategies has been validated by prospective studies to date. In this review we illustrate the topic of incidental FSLs and we analyze a number of published algorithms.

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

Cited by 7 publications

References 25 publications

The clinical significance of biliary findings in magnetic resonance enterography of patients with inflammatory bowel disease

The clinical significance of biliary findings in magnetic resonance enterography of patients with inflammatory bowel disease

Large Bowel Ischemia/Infarction: How to Recognize It and Make Differential Diagnosis? A Review

Incidental Focal Spleen Lesions: Integrated Imaging and Pattern Recognition Approach to the Differential Diagnosis

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