Computed tomography and magnetic resonance imaging in the evaluation of pelvic peritoneal adhesions: What radiologists need to know?

Abstract

Pelvic peritoneal adhesions constitute an important cause of concern which affects the life of millions of people worldwide due to complications like abdominal pain, bowel obstruction and infertility along with challenges in surgical exploration. Precise pre-operative diagnosis of the presence and extent of peritoneal adhesions is of great clinical and surgical importance. Diagnostic laparoscopy to detect peritoneal adhesions may itself lead to formation of adhesions. Routine CT and MRI studies are therefore useful non-invasive modalities to achieve this objective. This review article provides a brief background about the causation and patho-physiology of peritoneal adhesions. The article also addresses the range of clinical presentations in these patients, mainly from the gynecologic perspective. This article provides an illustrative review of CT and MRI findings with laparoscopic correlation. A new ‘imaging-based grading system’ for pre-operative quantification of the burden of peritoneal adhesions is also proposed. Despite practical challenges in accurate pre-operative diagnosis of peritoneal adhesions on imaging, detection of peritoneal adhesions is certainly feasible on routine CT and MRI scans and should be an integral part of image interpretation.

Role of Multidetector Computed Tomography with Multiplanar and Curved Multiplanar Reformations in the Detection of Cause of Intestinal Obstruction: A Tertiary Care Experience

“…It is reported that 60% of small bowel obstructions are due to adhesions, with 80% of cases occurring after surgery [10]. Adhesive small bowel obstruction is seen in 3% of all laparotomies and can occur as early as within three days to two weeks, with 40% formed within one year [11]. Other causes of adhesion are inflammation, seen in 15% of cases, and rare cases are due to congenital or unexplained causes [10][11].…”

“…Adhesive small bowel obstruction is seen in 3% of all laparotomies and can occur as early as within three days to two weeks, with 40% formed within one year [11]. Other causes of adhesion are inflammation, seen in 15% of cases, and rare cases are due to congenital or unexplained causes [10][11]. Pongpornsup S et al studied the various causes of bowel obstruction and found adhesions as the most common cause of bowel obstruction.…”

The role of MDCT in the diagnosis of small bowel obstruction secondary to multiple adhesion bands: A case report

“…However, "small bowel feces sign" is more commonly seen in the matted adhesion [2]. The focal obliteration of properitoneal fat line is also another sign of adhesion [19], which is observed in axial and sagittal reconstruction images. Adhesion may be vascularized and show enhancement in the post-contrast images.…”

“…Caoili et al emphasized that the detection and better delineation of the transition zone were possible in coronal reconstruction images [27]. It should be noted that the detection of thin adhesion needs localizing features, such as triangulation of picture archiving and commutating system [19]. Consequently, the multiplanar capabilities of CT make this modality feasible for visibility of the adhesive band, which can improve the surgical outcome and prognosis of patients.…”

Features of Laparoscopic Operations in Patients After Abdominal Cavity Interventions

“…Достоверность метода составляет от 60 до 96%, специфичность -91%, чувствительность -86%. С этой целью может быть использована компьютерная томография (чувствительность -87,5%, специфичность -92,5%) [6][7][8].…”