Lienemann A, Sprenger D, Steitz H O, Korell M, Reiser M
Department of Diagnostic Radiology, Klinikum Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr 15, D-81377 Munich, Germany.
Radiology. 2000 Nov;217(2):421-5. doi: 10.1148/radiology.217.2.r00oc23421.
To identify and map intraabdominal adhesions by using functional cine magnetic resonance (MR) Imaging.
Twenty-seven patients suspected of having intraabdominal adhesions were examined. Section-by-section dynamic depiction of induced visceral slide throughout the whole abdomen was achieved by using a transverse or sagittal true fast imaging with steady-state precession sequence. Location and type of diagnosed adhesions were documented by using the nine segments of the abdominal map. These criteria and intraoperative results were compared in 13 patients.
MR images depicted a total of 42 intraabdominal adhesions; 21 (50%) were in the lower abdomen. The most common types of adhesions were located between the ventral abdominal wall and small-bowel loops (n = 10 [24%]) and between adjacent small-bowel loops (n = 9 [21%]). Comparison with the intraoperative results showed a sensitivity of 87.5% and a specificity of 92.5%. MR imaging was most accurate in depicting adhesions to the abdominal wall (15 [94%] of 16) and subperitoneal space (eight [100%] of eight). The presence of adhesions between bowel loops was overestimated.
Detection of visceral slide at functional cine MR imaging is easy to perform and represents a well-tolerated and accurate procedure for use in the identification of intraabdominal adhesions in patients with chronic pain and equivocal clinical findings.
利用功能电影磁共振成像识别并绘制腹腔内粘连情况。
对27例疑似腹腔内粘连的患者进行检查。采用横轴位或矢状位稳态进动快速成像序列，对整个腹部进行逐节段动态描绘诱发的内脏滑动。利用腹部图谱的九个分区记录诊断出的粘连部位和类型。对13例患者的这些标准与术中结果进行比较。
磁共振图像共显示42处腹腔内粘连；21处（50%）位于下腹部。最常见的粘连类型位于腹前壁与小肠袢之间（n = 10 [24%]）以及相邻小肠袢之间（n = 9 [21%]）。与术中结果比较显示，灵敏度为87.5%，特异度为92.5%。磁共振成像在描绘腹壁粘连（16例中的15例 [94%]）和腹膜下间隙粘连（8例中的8例 [100%]）方面最为准确。肠袢之间粘连的存在情况被高估了。
在功能电影磁共振成像中检测内脏滑动操作简便，是一种耐受性良好且准确的方法，可用于识别慢性疼痛且临床检查结果不明确的患者的腹腔内粘连。
