title: In vivo MRI visualization of parastomal mesh in a porcine model.
abstract: BACKGROUND
  After two-dimensional plane MRI-visible mesh implants could be successfully visualized in phantom and small animal model, the aim of the underlying study was to explore the feasibility of an MRI visualization of complex three-dimensional mesh geometry in close contact to the intestine. We therefore used a MR-visible three-dimensional intra-peritoneal stoma (IPST) mesh in a porcine model.
  
  
  METHODS
  Laparoscopic terminal sigmoid colostomy has been done with implantation of a prophylactic MRI-visible IPST mesh in two animals. MRI investigations were done after 1 week, 6 months and in case of clinical impairment. These findings were compared to endoscopy and makroscopical and histological investigation of the preparation.
  
  
  RESULTS
  The first animal has to be killed because of an ileus 4 weeks after operation. The second animal has to be killed after 7 weeks because of recurrent obstipation. In all cases MRI investigation could identify the IPST mesh and could clearly separate between mesh and intestine. MRI revealed a big bowl ileus due to a funnel dislocation in the first animal. In the second animal, MR diagnostic explored a functional stenosis because of a too small diameter of the central funnel in combination with sticky feces and distension of the terminal sigmoid before discharging into the funnel. Endoscopy, makroscopical and histological investigation of the preparation supported MRI findings.
  
  
  CONCLUSIONS
  Although complicate clinical course was a diagnostic challenge exploring 3D implants such as IPST, visualization of this new MRI-visible IPST mesh could be proved and turned out as an effective diagnostic possibility. Further studies are necessary to analyze long-time effects such as shrinkage, mesh migration and tissue integration using MRI scanning.
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Hospital, RWTH Aachen University, Aachen, Germany, jeotto@ukaachen.de.
authors.forename: J
authors.initials: J
authors.lastname: Otto
authors.forename: D
authors.initials: D
authors.lastname: Busch
authors.forename: C
authors.initials: C
authors.lastname: Klink
authors.forename: A
authors.initials: A
authors.lastname: Ciritsis
authors.forename: A
authors.initials: A
authors.lastname: Woitok
authors.forename: C
authors.initials: C
authors.lastname: Kuhl
authors.forename: U
authors.initials: U
authors.lastname: Klinge
authors.forename: U P
authors.initials: UP
authors.lastname: Neumann
authors.forename: N A
authors.initials: NA
authors.lastname: Kraemer
authors.forename: J
authors.initials: J
authors.lastname: Conze
mesh_terms: D000818:Animals; D001672:Biocompatible Materials; D004195:Disease Models, Animal; D004766:Enterostomy; D005240:Feasibility Studies; D005290:Ferric Compounds; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D008297:Male; D008567:Membranes, Artificial; D011145:Polyvinyls; D013526:Surgical Mesh; D013552:Swine; D005465:Fluorocarbon Polymers
chemical_list: D001672:Biocompatible Materials; D005290:Ferric Compounds; D008567:Membranes, Artificial; D011145:Polyvinyls; C000499:ferric oxide; C024865:polyvinylidene fluoride; D005465:Fluorocarbon Polymers