Detection of recurrent hernia and intraabdominal adhesions following incisional hernia repair: A functional cine MRI-study

Background: To non-invasively identify incisional hernia repair implanted synthetic meshes with MRI, and also focusing on the evaluation of postsurgical complications such as adhesions. Methods: A total of 43 patients underwent either laparoscopic intraperitoneal onlay-mesh or open abdominal wall repair using preperitoneal layers. The patients were examined using a true-fast-imaging-with-steadystate-precession (trueFISP)-sequence in transverse/sagittal orientation with a section-by-section dynamic depiction of induced visceral slide. A 9-segment-abdominalmap was used to document the adhesion location/type. The MR-images were analysed regarding hernia relapse, layer-morphology, rectus-abdominis muscle-condition, and abdominal wall mobility. In 12 patients pre-and postsurgery-MRI was performed. Results: Time range between surgery and examination was 6-36 months. In all laparoscopy-patients the meshes were identified. For open surgery the mesh was not visualized in 20, but was seen in 6 cases. A total of 11 cases showed a recurrent hernia. Seventy intraabdominal adhesions were detected. Fifteen patients had restricted mobility. 20 patients showed an rectus-abdominismuscle- asymmetry. Comparing pre-and post-op-MRI, 6 out of 8 patients with open repair showed thick scarplaques. Three patients with open repair had new adhesion-formations postoperatively. Conclusion: Functional cine MRI is suitable for followup studies in patients after hernia repair to detect and evaluate the implanted meshes. Typical complications like intestinal adhesions and abdominal wall dysmotility can be assessed as well.