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Detection and Mapping of Intraabdominal Adhesions by Using Functional Cine MR Imaging: Preliminary Results¹

¹ From the Departments of Diagnostic Radiology (A.L., D.S., M.R.), Surgery (H.O.S.), and Obstetrics and Gynecology (M.K.), Klinikum Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr 15, D-81377 Munich, Germany. Received July 7, 1999; revision requested September 9; revision received January 14, 2000; accepted January 27. Address correspondence to A.L. (e-mail: andreasliene@compuserve.com).

PURPOSE: To identify and map intraabdominal adhesions by using functional cine magnetic resonance (MR) Imaging.

MATERIALS AND METHODS: 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.

RESULTS: 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.

CONCLUSION: 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.

Index terms: Abdomen, abnormalities, 70.293, 70.458, 70.89 • Abdomen, MR, 70.121419 • Intestines, stenosis or obstruction, 74.723 • Magnetic resonance (MR), cine study, 70.121419 • Magnetic resonance (MR), functional imaging, 70.121419 • Peritoneum, abnormalities, 70.293 • Peritoneum, MR, 70.121419

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