A Concept for Magnetic Resonance Visualization of Surgical Textile Implants

Purpose:To develop a method for visualizing surgical textile implant (STI) with superparamagnetic iron oxides (SPIO), using magnetic resonance imaging (MRI). Therefore, positive-contrast inversion-recovery with on-resonant water suppression (IRON) was applied and its properties were evaluated in vitro. Materials and Methods:STI with different concentrations of SPIO integrated into the base material were produced. Imaging was performed on a clinical 1.5 Tesla scanner, using conventional balanced gradient echo sequences (SSFP), T2*-weighted sequences, and IRON-imaging. In vitro experiments were conducted in an agarose phantom. On MR-images, contrast-to-noise-ratios, and the dimensions of the implant were assessed. Results:Conventional MRI exhibited SPIO-loaded STI as signal voids. Using IRON, the mesh was clearly exhibited hyperintensely with suppression of on-resonant background signals with a distinct differentiation to other sources of off-resonances. Concentrations of approximately 9 mg/g led to best positive contrast and highest contrast-to-noise-ratios using IRON. Depending on B0-orientation, phase encoding direction and the STI's SPIO-load, the IRON-signal showed a characteristic pattern and an overestimation of STI size up to 4.6 mm. Conclusion:The integration of SPIOs into the base material combined with IRON is a feasible approach to visualize STI with MRI. This method could help to identify mesh-related problems in time and to reduce the need for surgical revision.

[1]  Off-resonance angiography: a new method to depict vessels--phantom and rabbit studies. , 2008, Radiology.

[2]  M. Kuroda,et al.  Composition of MRI phantom equivalent to human tissues. , 2005, Medical physics.

[3]  T. Schmitz-Rode,et al.  Use of a Nonmetallic Guide Wire for Magnetic Resonance-Guided Coronary Artery Catheterization , 2004, Investigative radiology.

[4]  E. Atalar,et al.  MR‐trackable intramyocardial injection catheter , 2004, Magnetic resonance in medicine.

[5]  J. Jeekel,et al.  A comparison of suture repair with mesh repair for incisional hernia. , 2000, The New England journal of medicine.

[6]  W. P. Reed,et al.  Long-term complications associated with prosthetic repair of incisional hernias. , 1998, Archives of surgery.

[7]  Markus Völk,et al.  Magnetic Resonance-Guided Percutaneous Angioplasty of Femoral and Popliteal Artery Stenoses Using Real-Time Imaging and Intra-arterial Contrast-Enhanced Magnetic Resonance Angiography , 2005, Investigative radiology.

[8]  D. Kraitchman,et al.  Positive contrast MR‐lymphography using inversion recovery with ON‐resonant water suppression (IRON) , 2008, Journal of magnetic resonance imaging : JMRI.

[9]  A. Kingsnorth The management of incisional hernia. , 2006, Annals of the Royal College of Surgeons of England.

[10]  John M Pauly,et al.  Positive contrast magnetic resonance imaging of cells labeled with magnetic nanoparticles , 2005, Magnetic resonance in medicine.

[11]  Wei Liu,et al.  Susceptibility gradient mapping (SGM): A new postprocessing method for positive contrast generation applied to superparamagnetic iron oxide particle (SPIO)‐labeled cells , 2008, Magnetic resonance in medicine.

[12]  J. Grönroos,et al.  Mesh repair of common abdominal hernias: a review on experimental and clinical studies , 2008, Hernia.

[13]  I. Rutkow,et al.  Demographic and socioeconomic aspects of hernia repair in the United States in 2003. , 2003, The Surgical clinics of North America.

[14]  H. Kehlet,et al.  Pain and functional impairment 6 years after inguinal herniorrhaphy , 2006, Hernia.

[15]  B. Klosterhalfen,et al.  Functional and morphological evaluation of a low-weight, monofilament polypropylene mesh for hernia repair. , 2002, Journal of biomedical materials research.

[16]  G. Ferzli,et al.  Chronic pain after inguinal herniorrhaphy. , 2007, Journal of the American College of Surgeons.

[17]  Debiao Li,et al.  Generating positive contrast from off-resonant spins with steady-state free precession magnetic resonance imaging: theory and proof-of-principle experiments , 2006, Physics in medicine and biology.

[18]  R. Günther,et al.  Preclinical Evaluation of a Novel Fiber Compound MR Guidewire In Vivo , 2009, Investigative radiology.

[19]  Sophie Laurent,et al.  Contrast agents: magnetic resonance. , 2008, Handbook of experimental pharmacology.

[20]  R. Kreis,et al.  Open surgical procedures for incisional hernias. , 2008, The Cochrane database of systematic reviews.

[21]  D. Kraitchman,et al.  Noninvasive detection of macrophage-rich atherosclerotic plaque in hyperlipidemic rabbits using "positive contrast" magnetic resonance imaging. , 2008, Journal of the American College of Cardiology.

[22]  Charles H Cunningham,et al.  Positive-contrast imaging in the rabbit hind-limb of transplanted cells bearing endocytosed superparamagnetic beads. , 2006, Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance.

[23]  U Klinge,et al.  Impact of polymer pore size on the interface scar formation in a rat model. , 2002, The Journal of surgical research.

[24]  A. Imai,et al.  Frequency of postoperative inguinal hernia after endoscope‐assisted mini‐laparotomy and conventional retropubic radical prostatectomies , 2008, International journal of urology : official journal of the Japanese Urological Association.

[25]  T. Schmitz-Rode,et al.  Synthesis, physicochemical characterization and MR relaxometry of aqueous ferrofluids. , 2008, Journal of nanoscience and nanotechnology.

[26]  Shao-Pow Lin,et al.  MR contrast agents: Physical and pharmacologic basics , 2007, Journal of magnetic resonance imaging : JMRI.

[27]  Seung-Schik Yoo,et al.  Positive contrast visualization for cellular magnetic resonance imaging using susceptibility-weighted echo-time encoding. , 2009, Magnetic resonance imaging.

[28]  A. Hamouda,et al.  Mesh erosion into the urinary bladder following laparoscopic inguinal hernia repair; is this the tip of the iceberg? , 2010, Hernia.

[29]  Matthias Stuber,et al.  Positive contrast visualization of nitinol devices using susceptibility gradient mapping , 2008, Magnetic resonance in medicine.

[30]  E. Verdaasdonk,et al.  Long-term Follow-up of a Randomized Controlled Trial of Suture Versus Mesh Repair of Incisional Hernia , 2004, Annals of surgery.

[31]  F. Floris,et al.  Imaging of early postoperative complications after polypropylene mesh repair of inguinal hernia. , 2004, La Radiologia medica.

[32]  G. Adam,et al.  In vivo magnetic resonance imaging of iron oxide–labeled, arterially‐injected mesenchymal stem cells in kidneys of rats with acute ischemic kidney injury: Detection and monitoring at 3T , 2007, Journal of magnetic resonance imaging : JMRI.

[33]  F. Korosec,et al.  Real-time MR imaging-guided passive catheter tracking with use of gadolinium-filled catheters. , 2000, Journal of vascular and interventional radiology : JVIR.

[34]  J Hennig,et al.  Alternating repetition time balanced steady state free precession , 2006, Magnetic Resonance in Medicine.

[35]  Matthias Stuber,et al.  Positive contrast visualization of iron oxide‐labeled stem cells using inversion‐recovery with ON‐resonant water suppression (IRON) , 2007, Magnetic resonance in medicine.