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Comparative study among cine-magnetic resonance imaging, ultrasound, and periumbilical ultrasound-guided saline infusion in high-risk patients for subumbilical adhesions before laparoscopic entry

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Gynecological Surgery

Abstract

Abdominal entry at the time of laparoscopy remains the most critical step in laparoscopic surgery. Transabdominal ultrasound (TAU) and cine magnetic resonance imaging (cine-MRI) are both non-invasive tools in the preoperative prediction of adhesions. Ultrasound is effective in detecting abdominal wall adhesions, but MRI is the best for intra-abdominal adhesions. Periumbilical ultrasound-guided saline infusion (PUGSI) is an excellent method for detecting subumbilical adhesions. Evaluate the most effective and rapid method for diagnosis of subumbilical adhesions before laparoscopic interference in gynecological practice. This study was carried out on 90 high-risk patients for subumbilical adhesions. All patients were subjected to medical history, physical examination, laboratory investigations, and three techniques for subumbilical adhesions detection before laparoscopic entry including cine-MRI, TAU, and PUGSI. PUGSI for detection of subumbilical adhesions showed that the sensitivity of 94.7 % and a specificity of 90.1 %. With preoperative TAU, a sensitivity of 89.5 % and a specificity of 88.7 % were obtained. With cine-MRI, a sensitivity of 78.9 % and a specificity of 84.5 % were obtained. PUGSI is a more sensitive and rapid method than TAU and cine-MRI for detection of subumbilical adhesions before laparoscopic gynecological surgery.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Mohamed Lotfy, Ibrahim Abdel Gafor & Ahmed Mahmoud Abdo

  2. Department of Radiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Ahmed Abdel Azim

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  1. Mohamed Lotfy
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  2. Ibrahim Abdel Gafor
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  3. Ahmed Mahmoud Abdo
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  4. Ahmed Abdel Azim
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Correspondence to Mohamed Lotfy.

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Lotfy, M., Gafor, I.A., Abdo, A.M. et al. Comparative study among cine-magnetic resonance imaging, ultrasound, and periumbilical ultrasound-guided saline infusion in high-risk patients for subumbilical adhesions before laparoscopic entry. Gynecol Surg 13, 93–96 (2016). https://doi.org/10.1007/s10397-015-0919-z

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  • DOI: https://doi.org/10.1007/s10397-015-0919-z

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