Cine-MRI detection of intraabdominal adhesions: correlation with intraoperative findings in 89 consecutive cases.
BACKGROUND
This study aimed to evaluate the accuracy of functional cine-MRI in detecting abdominal adhesions.


METHODS
For this study, 89 consecutive patients with adhesion-related complaints after previous abdominal surgery underwent preoperative workup including cine-MRI in transverse and sagittal orientations for a dynamic examination of an induced visceral slide. An abdominal map consisting of nine segments was created to document the location and extent of the adhesion. Cine-MRI and intraoperative findings were correlated.


RESULTS
A total of 59 laparotomies and 30 laparoscopies were performed. Four cases required open surgery due to severe adhesions. The use of cine-MRI scan for the detection of adhesions showed an overall accuracy of 90%, a sensitivity of 93%, and a positive predictive value of 96%. The stronger the adhesions, the more accurate the scan findings. Of 44 patients with second-degree MRI scan findings, 50% had second-degree intraoperative findings. Of 35 patients with third- and fourth-degree adhesions on MRI scans, 74% had exactly the same intraabdominal findings at surgery. The MRI scan showed adhesions located in the small intestines (75%), large intestines (35%), abdominal cavity (42%), and reproductive organs (32%). Intraoperatively, adhesions were found in the small intestines (70%), large intestines (40%), abdominal cavity (42%), and reproductive organs (28%).


CONCLUSIONS
Cine-MRI provides valid preoperative information with respect to extent, location, and strength of intraabdominal adhesions. Cine-MRI is a good alternative for diagnosing abdominal adhesions because objective findings of the scan and intraoperative findings correlate very well with each other.
Lang
Reinhold A
RA
Department of Surgery, Klinikum Grosshadern, University of Munich, Marchioninistrasse 15, D-81377, Munich, Germany. Reinhold.Lang@med.uni-muenchen.de
Buhmann
Sonja
S
Hopman
Alexander
A
Steitz
Heinrich-Otto
HO
Lienemann
Andreas
A
Reiser
Maximilian F
MF
Jauch
Karl-Walter
KW
Hüttl
Thomas P
TP
D034841:Abdominal Cavity / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D010535:Laparoscopy; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D000267:Tissue Adhesions / Q000175:diagnosis* / Q000601:surgery*