Division of Gastroenterology, Department of Surgery, University Hospital of Oulu, Oulu, Finland.
Medical Research Center Oulu, University of Oulu, Oulu, Finland.
Tech Coloproctol. 2019 Jul;23(7):633-637. doi: 10.1007/s10151-019-02022-w. Epub 2019 Jul 3.
Magnetic resonance imaging (MRI) provides excellent information about pelvic anatomy after ventral rectopexy, but the position of the conventional mesh is not seen constantly. Iron oxide-impregnated polyvinylidene fluoride (PVDF) meshes are proven to have MRI visibility in hernia or vaginal reconstructive surgery. This prospective pilot study was designed to assess the visualization, position, and shape of the magnetic resonance (MR)-visible synthetic pelvic mesh used in minimally invasive ventral rectopexy.
Eight patients with pelvic organ prolapse were recruited for laparoscopic (LVMR) or robotic-assisted ventral mesh rectopexy (RVMR) with a synthetic MR-visible PVDF mesh. A follow-up visit was scheduled at 3 months after surgery. MR imaging was performed to evaluate the position and dimensions of the mesh and anatomical result. The visibility of the mesh in each sequence was assessed subjectively.
The visibility of the mesh was best on T1-weighted flash images. The mesh was also well visualized on T2-weighted sagittal images. T2-weighted images, in general, provided best visualization of the surrounding anatomical structures and enabled assessment of the mesh fixation.
T2 sagittal and T1-weighted flash images provide the best information about the position and integrity of the iron oxide-impregnated PVDF mesh after LVMR or RVMR with a short examination time.
磁共振成像(MRI)能为腹侧直肠固定术后的骨盆解剖结构提供极佳的信息,但常规网片的位置无法持续显示。铁氧化物浸渍聚偏二氟乙烯(PVDF)网片已被证实可用于疝或阴道重建手术的 MRI 可视性。本前瞻性初步研究旨在评估微创腹侧直肠固定术中使用的具有 MRI 可视性的合成骨盆网片的可视化、位置和形状。
8 名盆腔器官脱垂患者接受腹腔镜(LVMR)或机器人辅助腹侧网片直肠固定术(RVMR),使用合成的具有 MRI 可视性的 PVDF 网片。术后 3 个月安排随访。进行磁共振成像(MRI)以评估网片的位置和尺寸以及解剖结果。主观评估每个序列中网片的可视性。
T1 加权闪烁图像上的网片可见度最佳。T2 加权矢状图像上也能很好地显示网片。一般来说,T2 加权图像能提供周围解剖结构的最佳可视化效果,并能评估网片固定情况。
T2 矢状位和 T1 加权闪烁图像在 LVMR 或 RVMR 后能提供关于铁氧化物浸渍 PVDF 网片位置和完整性的最佳信息,且检查时间较短。