MRI‐enema for the assessment of pelvic intestinal anastomotic integrity

Worley, Guy; Burling, David; Corr, Alison; Clark, Susan; Baldwin-Cleland, Rachel; Faiz, Omar; Jenkins, John T.

doi:10.1111/codi.15688

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…Guy et al compared MRI-enema with fluoroscopic water-soluble contrast enema in the assessment of pelvic intestinal anastomotic integrity and found that MRI-enema offers a more detailed assessment of anastomotic leakage, providing additional pelvic information and an equivalent patient experience [ 25 ]. Although patients received MRI examination without enema in our study, the accuracy was satisfactory.…”

Section: Discussionmentioning

confidence: 99%

MRI diagnose post-operative anastomotic leak in patients with rectal cancer: preliminary experience

Chen

Wang

et al. 2022

BMC Surg

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Background Anastomotic leakage (AL) is one of the most serious postoperative complications after colorectal anastomosis. This study aims to evaluate the feasibility and diagnostic accuracy of magnetic resonance imaging (MRI) in the early detection of AL in patients with clinically suspected AL after rectal anterior resection. Methods This was a prospective study including patients who underwent anterior resection and postoperative MRI examination. AL was diagnosed by comprehensive indictors, which were mainly confirmed by clinical signs, symptoms, and retrograde contrast enema (RCE) radiography. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of diagnosing AL with MRI were calculated. Results In total, 347 patients received anterior resection for rectal cancer, and 28 patients were suspected to have AL. Finally, 23 patients were included and received MRI examination. The median time interval from surgery to MRI was 10 days (3–21 days). The median distance from anastomosis to anal verge was 4.0 cm (2.0–10 cm), and 11 patients underwent diverted ileostomy. Eighteen patients had an anastomotic leak, including one patient who had a pelvic abscess and five patients who had no evidence of AL in the MRI examination. The overall sensitivity and specificity were 94.4% (95% CI 70.6% to 99.7%) and 80% (95% CI 29.8% to 98.9%), respectively. The PPV was 0.94 (95% CI 0.71 to 0.99) and the NPV was 0.80 (95% CI 0.29 to 0.99). For patients who had anastomosis less than 5 cm, the diagnostic accuracy of MRI was 93.7% (15/16). T2-weighted imaging with fat suppression can effectively reveal the leak track. Conclusions The accuracy of plain MRI examination in diagnosing AL was favorable for patients with a suspected AL. T2-weighted imaging with fat suppression was the best imaging modality to diagnose AL. A multicenter prospective study with more samples is needed to further determine the safety and feasibility of MRI in the diagnosis of AL.

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Section: Discussionmentioning

confidence: 99%

MRI diagnose post-operative anastomotic leak in patients with rectal cancer: preliminary experience

Chen

Wang

et al. 2022

BMC Surg

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“…Guy et al has compared MRI-enema with uoroscopic water-soluble contrast enema in the assessment of pelvic intestinal anastomotic integrity, and found MRI-enema offers more detailed assessment of anastomotic leak, with additional pelvic information and equivalent patient experience [24] . Although patients received MR examination without enema in our study, the accurate was satisfying.…”

Section: Discussionmentioning

confidence: 99%

MRI diagnose post-operative anastomotic leak in patients with rectal cancer: preliminary experience

Chen

Wang

et al. 2022

Preprint

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Background: Anastomotic leakage (AL) was one of the most serious postoperative complications after colorectal anastomosis. This study aims to evaluate the feasibility and diagnostic accuracy of Magnetic resonance imaging (MRI) in the early detection of AL in patients with clinically suspected AL after rectal anterior resection.Methods: This was a prospective study including patients who underwent anterior resections and post-operative MRI examination. The sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) of diagnosing AL of MRI were calculated.Results: Total of 23 patients received MRI after surgery and the median time interval from surgery to MRI was 10 days (3-21 days). The median distance from anastomosis to anal verge was 4.0cm (2.0-10cm), and 11 patients underwent diverted ileostomy. Eighteen patients were found to had an anastomotic leak, including one patient who had a pelvic abscess, and five patients who had no evidence of AL in the MRI examination. the overall sensitivity and specificity were 94.4% (17/18) and 80% (4/5), respectively. The PPV was 0.94 and the NPV was 0.80. For patients who had anastomosis lower than 5cm, the diagnostic accuracy of MRI was 93.7% (15/16). T2-weighted with fat-suppression can show the leak track well.Conclusions: The accuracy of plain MRI examination in diagnosing AL was favorable for patients who were suspected of AL. T2-weighted with fat-suppression was the best imaging to estimate the AL.The multi-center prospective study with more samples is needed to further estimate the safety and feasibility of MR in diagnosing the AL.

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Considerations in case of suspected anastomotic leakage in the lower GI tract

de Wit,

Daams

2024

Best Practice & Research Clinical Gastroenterology

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MRI‐enema for the assessment of pelvic intestinal anastomotic integrity

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 4 publications

References 19 publications

MRI diagnose post-operative anastomotic leak in patients with rectal cancer: preliminary experience

MRI diagnose post-operative anastomotic leak in patients with rectal cancer: preliminary experience

MRI diagnose post-operative anastomotic leak in patients with rectal cancer: preliminary experience

Considerations in case of suspected anastomotic leakage in the lower GI tract

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