Magnetic Resonance Imaging and Abdominal Wall Hernias in Aortic Surgery

Musella, Mario; Milone, Francesco; Chello, Massimo; Angelini, Pierluigi; Jovino, R

doi:10.1016/s1072-7515(01)01003-1

Cited by 49 publications

(51 citation statements)

References 22 publications

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“…The PRISMA flow diagram is shown in addendum 3 (Key Question A). Fifteen records were included in the qualitative analysis [3][4][5][6][50][51][52][53][54][55][56][57][58][59][60]. Only four studies were retained as High Quality and are listed in the Summary of Findings table (Table 2) [5, [50][51][52].…”

Section: Resultsmentioning

confidence: 99%

European Hernia Society guidelines on the closure of abdominal wall incisions

Muysoms

Antoniou

Bury

et al. 2015

Hernia

510

406

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Section: Resultsmentioning

confidence: 99%

European Hernia Society guidelines on the closure of abdominal wall incisions

Muysoms

Antoniou

Bury

et al. 2015

Hernia

510

406

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“…However, most of the diagnoses included in the analysis were made clinically. Musella et al [7] found an incidence of 31.7% for incisional hernias after a follow-up of 4 years in their patients, who were diagnosed by MRI and US. They concluded that US was unreliable in the early detection of anterior wall hernias and that US was more accurate in detecting normal rather than abnormal abdominal walls.…”

Section: Discussionmentioning

confidence: 88%

“…Patients with an abdominal aortic aneurysm have a high incidence of ventral hernias. For instance, in a study comparing US and magnetic resonance imaging (MRI), the incidence of incisional hernias was 31.7% after reconstruction for abdominal aortic aneurysm after a mean duration of follow-up of 48.6 months [7]. In a systematic literature review, the pooled incidence of a postoperative incision hernia was 21% in abdominal aortic aneurysm patients and 9.8% in patients with aortoiliac occlusive disease [8].…”

Section: Introductionmentioning

confidence: 99%

Comparison of ultrasonography with computed tomography in the diagnosis of incisional hernias

Hartog

Dur

Kamphuis

et al. 2008

Hernia

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Background The objective of this study is to determine the reliability and validity of ultrasonography (US) in diagnosing incisional hernias in comparison with computed tomography (CT). The CT scans were assessed by two radiologists in order to estimate the inter-observer variation and twice by one radiologist to estimate the intra-observer variation. Patients were evaluated after reconstruction for an abdominal aortic aneurysm or an aortoiliac occlusion. Methods Patients with a midline incision after undergoing reconstruction of an abdominal aortic aneurysm or aortoiliac occlusion were examined by CT scanning and US. Two radiologists evaluated the CT scans independently. One radiologist examined the CT scans twice. Discrepancies between the CT observations were resolved in a common evaluation session between the two radiologists.Results After a mean follow-up of 3.4 years, 40 patients were imaged after a reconstructed abdominal aortic aneurysm (80% of the patients) or aortoiliac occlusion. The prevalence of incisional hernias was 24/40 = 60.0% with CT scanning as the diagnostic modality and 17/40 = 42.5% with US. The measure of agreement between CT scanning and US expressed as a Kappa statistic was 0.66 (95% conWdence interval [CI] 0.45-0.88). The sensitivity of US examination when using CT as a comparison was 70.8%, the speciWcity was 100%, the predictive value of a positive US was 100%, and the predictive value of a negative US was 69.6%. The likelihood ratio of a positive US was inWnite and that of a negative US was 0.29. The inter-and intraobserver Kappa statistics were 0.74 (CI 0.54-0.95) and 0.80 (CI 0.62-0.99), respectively. Conclusions US imaging has a moderate sensitivity and negative predictive value, and a very good speciWcity and positive predictive value. Consistency of diagnosis, as determined by calculating the inter-and intra-observer Kappa statistics, was good. The incidence of incisional hernias is high after aortic reconstructions.

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“…CT is the mostly used image modality to diagnose the incisional hernia, with sensitivity of 0.83 and specificity of 0.67 reported by one observational study [3]. MRI has the advantage of zero radiation and multiplanar tissue resolution [4], although evidence is still lacking regarding its sensitivity for hernia detection compared with CT. Diagnosis may remain difficult if the fascial defect is small or the patient is obese.…”

Section: Discussionmentioning

confidence: 99%

“…Detection of incisional hernia may be difficult in cases with obesity or small fascial defects [2]. Computed tomography (CT) [3] or magnetic resonance images (MRI) [4] provide adequate cross-sectional images for the abdominal wall, although both image modalities require patients to be examined in a supine position. We reported a case noticing a mass over her right lower abdomen after a laparoscopic liver segmentectomy with negative findings of hernias on MRI.…”

Section: Introductionmentioning

confidence: 99%

Dynamic ultrasound with postural change facilitated the detection of an incisional hernia in a case with negative MRI findings

et al. 2014

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Incisional hernias commonly develop after abdominal surgeries with a lower incidence in patients receiving laparoscopy. Diagnosis through a non-surgical approach is usually made by computed tomography or magnetic resonance images (MRI) but both image modalities require patients to be examined in a supine position. We reported a case noticing a mass over her right lower abdomen after a laparoscopic liver segmentectomy with negative findings of hernia on MRI. A hernia sac was found by ultrasound with the patient being standing, highlighting the utility of dynamic ultrasound with postural change in investigation of incisional hernias.Keywords CT Á MRI Á Ultrasound Á Incisional hernia Á Laparoscopy Sommario Il laparocele dopo interventi di chirurgia addominale si realizza con minore incidenza nei pazienti trattati con laparoscopia. La diagnosi non chirurgica di solito è fatta contomografia computerizzata o risonanza magnetica (MRI), ma entrambe le modalità richiedono che i pazienti siano esaminati in posizione supina. Presentiamo un caso di massa del basso addome, a destra, dopo segmentectomia epatica laparoscopica, con risultati negativi per ernia all'esame 24 MRI. L'ecografia, con paziente in piedi, ha evidenziato un sacco erniario, dimostrando l'utilità dell'ecografia dinamica, con cambio posturale, nelle indagini per laparocele.

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Magnetic Resonance Imaging and Abdominal Wall Hernias in Aortic Surgery

Cited by 49 publications

References 22 publications

European Hernia Society guidelines on the closure of abdominal wall incisions

European Hernia Society guidelines on the closure of abdominal wall incisions

Comparison of ultrasonography with computed tomography in the diagnosis of incisional hernias

Dynamic ultrasound with postural change facilitated the detection of an incisional hernia in a case with negative MRI findings

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