title: Time-dependent changes of magnetic resonance imaging-visible mesh implants in patients.
abstract: OBJECTIVE
  Shrinkage and deformation of mesh implants used for hernia treatment can be the cause of long-term complications. The purpose of this study was to quantify noninvasively time-dependent mesh shrinkage, migration, and configuration changes in patients who were surgically treated for inguinal hernia using magnetic resonance imaging (MRI)-visible mesh implants.
  
  
  METHODS
  In an agarose phantom, meshes in different shrinkage and folding conditions were used to validate the quantification process. Seven patients who were surgically (3 bilaterally) treated for inguinal hernia using iron-loaded mesh implants were prospectively examined using MRI. Gradient echo sequences in sagittal and transverse orientations were performed on day 1 after surgery and at day 90. The mesh-induced signal voids were semiautomatically segmented and a polygonal surface model was generated. A comparison of area and centroid position was performed between the 2 calculated surfaces (day 1 vs day 90).
  
  
  RESULTS
  The phantom study revealed a maximum deviation of 3.6% between the MRI-based quantification and the actual mesh size. All 10 implants were successfully reconstructed. The mean (SD) observed mesh shrinkage 90 days after surgery was 20.9% (7.1%). The mean (SD) centroid movement was 1.17 (0.47) cm. Topographic analysis revealed mean (SD) local configuration changes of 0.23 (0.03) cm.
  
  
  CONCLUSIONS
  In this study, significant mesh shrinkage (20.9%) but marginal changes in local mesh configuration occurred within 90 days after mesh implantation. Centroid shift of the mesh implant can be traced back to different patient positioning and abdominal distension. The developed algorithm facilitates noninvasive assessment of key figures regarding MRI-visible meshes. Consequently, it might help to improve mesh technology as well as surgical skills.
authors.affiliation: Departments of *Diagnostic and Interventional Radiology and †General, Visceral, and Transplant Surgery, RWTH University Hospital Aachen, Aachen, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Ciritsis
authors.forename: Nienke Lynn
authors.initials: NL
authors.lastname: Hansen
authors.forename: Alexandra
authors.initials: A
authors.lastname: Barabasch
authors.forename: Nicolas
authors.initials: N
authors.lastname: Kuehnert
authors.forename: Jens
authors.initials: J
authors.lastname: Otto
authors.forename: Joachim
authors.initials: J
authors.lastname: Conze
authors.forename: Uwe
authors.initials: U
authors.lastname: Klinge
authors.forename: Christiane K
authors.initials: CK
authors.lastname: Kuhl
authors.forename: Nils Andreas
authors.initials: NA
authors.lastname: Kraemer
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D019544:Equipment Failure Analysis / Q000379:methods*; D006547:Hernia / Q000473:pathology* / Q000628:therapy; D059685:Herniorrhaphy / Q000295:instrumentation*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D013526:Surgical Mesh; D013997:Time Factors; D016896:Treatment Outcome