title: A Novel Diagnostic Aid for Detection of Intra-Abdominal Adhesions to the Anterior Abdominal Wall Using Dynamic Magnetic Resonance Imaging.
abstract: Introduction. Abdominal adhesions can cause serious morbidity and complicate subsequent operations. Their diagnosis is often one of exclusion due to a lack of a reliable, non-invasive diagnostic technique. Development and testing of a candidate technique are described below. Method. During respiration, smooth visceral sliding motion occurs between the abdominal contents and the walls of the abdominal cavity. We describe a technique involving image segmentation and registration to calculate shear as an analogue for visceral slide based on the tracking of structures throughout the respiratory cycle. The presence of an adhesion is attributed to a resistance to visceral slide resulting in a discernible reduction in shear. The abdominal movement due to respiration is captured in sagittal dynamic MR images. Results. Clinical images were selected for analysis, including a patient with a surgically confirmed adhesion. Discernible reduction in shear was observed at the location of the adhesion while a consistent, gradually changing shear was observed in the healthy volunteers. Conclusion. The technique and its validation show encouraging results for adhesion detection but a larger study is now required to confirm its potential.
authors.affiliation: Medical Physics Group, Department of Cardiovascular Science, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK.
authors.forename: David
authors.initials: D
authors.lastname: Randall
authors.affiliation: Medical Physics Group, Department of Cardiovascular Science, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK.
authors.forename: John
authors.initials: J
authors.lastname: Fenner
authors.affiliation: The Rotherham NHS Foundation Trust, Rotherham Hospital, Moorgate Road, Rotherham S60 2UD, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Gillott
authors.affiliation: Radboud University Medical Centre, Department of Surgery, P.O. Box 9101, 6500 HB Nijmegen, Netherlands.
authors.forename: Richard
authors.initials: R
authors.lastname: Ten Broek
authors.affiliation: Radboud University Medical Centre, Department of Surgery, P.O. Box 9101, 6500 HB Nijmegen, Netherlands.
authors.forename: Chema
authors.initials: C
authors.lastname: Strik
authors.affiliation: The Rotherham NHS Foundation Trust, Rotherham Hospital, Moorgate Road, Rotherham S60 2UD, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Spencer
authors.affiliation: The Rotherham NHS Foundation Trust, Rotherham Hospital, Moorgate Road, Rotherham S60 2UD, UK.
authors.forename: Karna Dev
authors.initials: KD
authors.lastname: Bardhan