A Novel Diagnostic Aid for Detection of Intra-Abdominal Adhesions to the Anterior Abdominal Wall Using Dynamic Magnetic Resonance Imaging

Gastroenterology Research and Practice
David RandallKarna D Bardhan

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.

References

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Citations

Jan 7, 2017·Journal of Clinical Gastroenterology·Paavo PaajanenHannu Paajanen
Jun 28, 2018·The American Journal of Gastroenterology·Barend Arend Willem van den BeukelRichard Peter Gerardus Ten Broek

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Software Mentioned

ANTs Advanced Normalisation Toolkit
Sheffield Image Registration Toolkit ( ShIRT )

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