), patient discomfort, complexity of the examinations, selleck Romidepsin accessibility, costs, and finally the impact of incidental findings. In the present study, the detection rate of clinically significant lesions outside the small intestine was low. In contrast, incidental findings led to unnecessary examinations in a substantial number of patients. Hence, in comparison with other modalities the detection rate of important incidental lesions was too low to be an argument in itself for performing MRI-enterography in patients with suspected or known CD. Our study was limited by its retrospective design. Radiological reports were not performed with the focus on incidental findings, and underestimation of clinically unimportant findings are likely.

The study population contained a preponderance of women (ratio 2:1), which is reflected by the frequency of incidental findings in the female genitalia. The second most common finding was ovarian cysts, and lesions in the female genitals were common in all classification groups. It is well established that CD is more common in females (1.2-1.5:1) and in specialized centers for inflammatory bowel diseases the prevalence of women with irritable bowel syndrome is up to 4 times as high as that of men[17,18]. In conclusion, incidental findings were common in patients with known and suspected CD having MRI for evaluation of small intestinal disease. Additional examinations revealed important disease in only a minority of patients. However, a substantial number of patients experienced unnecessary morbidity because of the additional examinations of benign or normal conditions.

The detection rate of important incidental lesions not related to CD was too low to be an argument in itself for performing MRI-enterography in this group of patients. COMMENTS Background Magnetic resonance imaging (MRI) is increasingly used in the assessment of small bowel Crohn��s disease (CD). Unlike conventional radiology, MRI enables visualization of disease extension beyond the intestinal wall, i.e. abscesses and fistulas. However, some extra-intestinal findings are unexpected and without relation to CD (incidental findings). Research frontiers Only a few studies have described the clinical impact of incidental findings in abdominal MRI. Lesions may represent important diseases and benefit patients, but may also cause unnecessary morbidity because of the diagnostic work-up of benign lesions.

Innovations and breakthroughs In 2 recent studies using abdominal MRI techniques, Cilengitide extra-intestinal lesions of major clinical importance were common. However, these studies did not include the results of subsequent diagnostic work-up to reveal the benefit from detection of these findings. In the present study, incidental findings were common in patients having MRI for evaluation of small bowel CD. Additional examinations revealed important disease in a minority of patients.