001). Except for bilateral hip selleck chem joint effusion, all E3 and E4 findings were detected in patients with suspected CD, and one patient had 2 E3 findings (Table (Table22). Clinical impact of extra-intestinal findings Extra-intestinal findings resulted in 12 clinical interventions in 9 patients (3.2%). The interventions consisted of ultrasound examination in one, ultrasound-guided biopsy in one, contrast-enhanced ultrasound and biopsy in one, CT-scan in one, gynecological examination including transvaginal ultrasound in 5, surgery in one and biochemical tests in one (Table (Table3).3). Succeeding work-up resulted in 5 true positive extra-intestinal findings and 3 false positive findings. One patient with bilateral hip joint effusion failed to attend the follow-up ultrasound examination.

Table 3 Previously unknown extra-intestinal findings leading to further examinations and the result of diagnostic work-up In a patient with suspected CD, MRI showed an enlarged bladder. The patient was referred for further urological examinations, and was subsequently diagnosed with a previously unknown prostate cancer. In another patient, MRI revealed a 6 cm wide and 9 cm long abdominal aortic aneurysm. CT scan of the aorta confirmed the aneurysm, and ruled out rupture. Five patients diagnosed with one or more lesions associated with the female genitals had further diagnostic work-up. In one patient, MRI showed a 6 cm large lesion in the small pelvis, and the finding was confirmed with transvaginal ultrasound.

The patient underwent surgery, which showed a 5 cm �� 4 cm �� 5 cm torquated leiomyoma in the top of the uterus and 2 smaller leiomyomas in the anterior wall of the uterus. The surgeon performed a hysterectomy. Incidental findings in the colon MRI revealed incidental Carfilzomib findings located in the colon and not related to inflammatory bowel disease in 16 patients (5.7%, Table Table4),4), of whom 5 also had an extra-intestinal finding (E2 in all). In 12 patients, colonic findings were of minor or no clinical relevance. Four patients underwent additional examinations because of mucosal changes not characteristic of inflammatory bowel disease. The examinations revealed no pathological conditions. Table 4 Sixteen incidental findings located in the colon and their clinical impact DISCUSSION Few studies have dealt with incidental findings in abdominal MRI. In a recent retrospective study, Herfarth et al[13] analyzed extra-intestinal findings in MRI-enteroclysis. In 710 patients with suspected or known inflammatory bowel disease 57% had extra-intestinal lesions and 12% of the observed lesions were of major clinical importance. In 5 patients (0.