Abstract
Background
This study evaluated the visualization of the pelvic nerves using magnetic resonance imaging (MRI) combined with computed tomography (CT) to synthesize three-dimensional (3D) reconstruction images of the pelvic organs.
Methods
The CT and MRI scans were performed for patients with rectal cancer who underwent surgery. The out-of-phase image of LAVA-Flex was used to identify the pelvic nerves. The images of the pelvic nerves were extracted from the MRI scans, and those of the arteries and rectum and pelvis were extracted from the CT scans. Each extracted organ image was used to synthesize 3D reconstruction images.
Results
The MRI scan allowed adequate visualization of the pelvic splanchnic nerves, inferior hypogastric plexus, and obturator nerves. The comparison of 3D reconstruction images and intraoperative findings showed matched images.
Conclusion
We visualized the pelvic nerves using MRI and synthesized 3D reconstruction images of the pelvic organs. Preoperative confirmation of the location of the pelvic organs is important to prevent unanticipated injury during rectal cancer surgery.
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Drs. Toshihiro Nakao, Mitsuo Shimada, Kozo Yoshikawa, Takuya Tokunaga, Masaaki Nishi, Hideya Kashihara, Chie Takasu, Yuma Wada, and Toshiaki Yoshimoto have no conflicts of interest or financial ties to disclose.
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Nakao, T., Shimada, M., Yoshikawa, K. et al. Visualization of the pelvic nerves using magnetic resonance imaging for rectal cancer surgery. Surg Endosc 37, 4315–4320 (2023). https://doi.org/10.1007/s00464-022-09771-0
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DOI: https://doi.org/10.1007/s00464-022-09771-0