Yasemin Altıntas, Mehmet Bayrak, Omer Alabaz
Department of Radiology, Ozel Ortadogu Hospital, Adana, 01360, Turkey.
Department of General Surgery, Ozel Ortadogu Hospital, Adana, 01360, Turkey.
Eur J Radiol. 2020 May;126:108922. doi: 10.1016/j.ejrad.2020.108922. Epub 2020 Feb 29.
This cohort aimed to determine the efficacy and safety of abdominal ulrasonography and cine-MRI by a double-blind study in the diagnosis of intraabdominal organs and abdominal wall adhesions in patients with previous abdominal operations.
Between 2017 and 2019, 108 consecutive patients were prospectively included in the study. Visceral slide and induced visceral slide were measured during AU and cine-MRI. An abdominal map consisting of nine segments was created to document the location and extent of the adhesion. The degree and severity of the adhesions detected by the radiologist preoperatively and detected in surgery as the gold standard was recorded in the same abdominal zones. AU, c-MRI and intraoperative findings were correlated.
The mean age was 53.0 ± 10.3 years, body mass index was 30.4 ± 3.4, male (52.8 %) and female (47.2 %). According to the total nine zones, the sensitivity of AU was 91.4 %, specificity was 100 %, positive predictive value was 90.7 %, negative predictive value was 100 % and diagnostic accuracy was 87.9 %. Considering the total zones, the sensitivity of c-MRI was 90.8 %, specificity was 100 %, PPV was 90.7 %, NPV was 100 % and diagnostic accuracy was 91.7 %. A comparison of AU and c-MRI showed no significant difference in the detection of adhesions to the abdominal wall; however, c-MRI was superior in detecting intraabdominal organs adhesion.
We have demonstrated that AU and c-MRI are accurate for diagnosing adhesions in patients undergoing repeated surgery and may have a place on planning elective laparoscopic or open surgery to avoid bowel injury.
本队列研究旨在通过双盲研究确定腹部超声(AU)和电影磁共振成像(cine-MRI)在诊断既往有腹部手术史患者的腹腔内器官和腹壁粘连方面的有效性和安全性。
2017年至2019年期间,前瞻性纳入108例连续患者。在腹部超声和电影磁共振成像检查期间测量内脏滑动和诱发内脏滑动。创建一个由九个区域组成的腹部图谱,以记录粘连的位置和范围。术前由放射科医生检测并以手术结果作为金标准检测到的粘连程度和严重程度,记录在相同的腹部区域。将腹部超声、电影磁共振成像和术中发现进行相关性分析。
平均年龄为53.0±10.3岁,体重指数为30.4±3.4,男性占52.8%,女性占47.2%。根据总共九个区域,腹部超声的敏感性为91.4%,特异性为100%,阳性预测值为90.7%,阴性预测值为100%,诊断准确性为87.9%。考虑到所有区域,电影磁共振成像的敏感性为90.8%,特异性为100%,阳性预测值为90.7%,阴性预测值为100%,诊断准确性为91.7%。腹部超声和电影磁共振成像的比较显示,在检测腹壁粘连方面没有显著差异;然而,电影磁共振成像在检测腹腔内器官粘连方面更具优势。
我们已经证明,腹部超声和电影磁共振成像在诊断再次手术患者的粘连方面是准确的,并且在规划选择性腹腔镜或开放手术以避免肠损伤方面可能具有一定作用。