Detection of recurrent hernia and intraabdominal adhesions following incisional hernia repair: a functional cine MRI-study.
BACKGROUND
To non-invasively identify incisional hernia repair implanted synthetic meshes with MRI, and also focusing on the evaluation of postsurgical complications such as adhesions.


METHODS
A total of 43 patients underwent either laparoscopic intraperitoneal onlay-mesh or open abdominal wall repair using preperitoneal layers. The patients were examined using a true-fast-imaging-with-steady-state-precession (trueFISP)-sequence in transverse/sagittal orientation with a section-by-section dynamic depiction of induced visceral slide. A 9-segment-abdominal-map was used to document the adhesion location/type. The MR-images were analysed regarding hernia relapse, layer-morphology, rectus-abdominis muscle-condition, and abdominal wall mobility. In 12 patients pre- and postsurgery-MRI was performed.


RESULTS
Time range between surgery and examination was 6-36 months. In all laparoscopy-patients the meshes were identified. For open surgery the mesh was not visualized in 20, but was seen in 6 cases. A total of 11 cases showed a recurrent hernia. Seventy intraabdominal adhesions were detected. Fifteen patients had restricted mobility. 20 patients showed an rectus-abdominis-muscle-asymmetry. Comparing pre- and post-op-MRI, 6 out of 8 patients with open repair showed thick scar-plaques. Three patients with open repair had new adhesion-formations postoperatively.


CONCLUSIONS
Functional cine MRI is suitable for follow-up studies in patients after hernia repair to detect and evaluate the implanted meshes. Typical complications like intestinal adhesions and abdominal wall dysmotility can be assessed as well.
Kirchhoff
S
S
Department of Clinical Radiology, Hospital Grosshadern, Ludwig Maximilians University Munich, Munich, Germany. sonja.kirchhoff@med.uni-muenchen.de
Ladurner
R
R
Kirchhoff
C
C
Mussack
T
T
Reiser
M F
MF
Lienemann
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D046449:Hernia, Abdominal / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011126:Polypropylenes; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000175:diagnosis*; D012008:Recurrence; D013526:Surgical Mesh; D000267:Tissue Adhesions / Q000175:diagnosis*
D011126:Polypropylenes; D011138:Polytetrafluoroethylene