Swallowing MRI—a reliable method for the evaluation of the postoperative gastroesophageal situs after Nissen fundoplication View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-11-12

AUTHORS

Michael A. Arnoldner, Ivan Kristo, Matthias Paireder, Enrico P. Cosentini, Wolfgang Schima, Michael Weber, Sebastian F. Schoppmann, Christiane Kulinna-Cosentini

ABSTRACT

PurposeTo evaluate the diagnostic performance of swallowing MRI of the gastroesophageal junction (GEJ) in the postoperative care of patients after laparoscopic antireflux surgery (LARS)Material and methodsIn this institutional review board-approved prospective study, 79 symptomatic patients (mean age, 52.3 years; range, 26–80 years) were evaluated after laparoscopic Nissen fundoplication. MRI findings were correlated with revision surgery, endoscopy, and high-resolution manometry (HRM) as standard of reference. MRI was performed on a 3.0-T unit using T2-weighted half-Fourier acquisition single-shot turbo spin echo (HASTE) sequences for anatomical assessment of the GEJ followed by dynamic MR swallowing (fast low-angle shot sequences). Four independent readers (two radiologists, two surgeons) rated 83 MR scans according to defined criteria, such as wrap disruption, slipping, recurrent hiatal hernia, and esophageal motility disorder.ResultsWrap disruption was correctly diagnosed concordantly with the standard of reference in 87.8%, slipping in 81.5%, and recurrent hiatal hernia in 84.9% of the cases. For esophageal motility disorder, MRI interpretation was consistent with manometry in 66.2% of the subjects. Interobserver analysis showed substantial agreement for recurrent hiatal hernia (k = 0.703), moderate agreement for wrap disruption (k = 0.585), and fair agreement for motility disorder and slipping (k = 0.234 and k = 0.200, respectively).ConclusionMR swallowing readily depicts the major failure mechanisms of LARS and has good reliability even in non-experienced readers.Key Points• MR swallowing accurately readily depicts the major failure mechanisms of laparoscopic antireflux surgery and has good reliability even in non-experienced readers.• It should be included in the preoperative workup for revision surgery after fundoplication.• It will be of great benefit to surgeons in considering and planning a reoperation. More... »

PAGES

4400-4407

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00330-018-5779-2

DOI

http://dx.doi.org/10.1007/s00330-018-5779-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1109828636

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30421012


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37 schema:description PurposeTo evaluate the diagnostic performance of swallowing MRI of the gastroesophageal junction (GEJ) in the postoperative care of patients after laparoscopic antireflux surgery (LARS)Material and methodsIn this institutional review board-approved prospective study, 79 symptomatic patients (mean age, 52.3 years; range, 26–80 years) were evaluated after laparoscopic Nissen fundoplication. MRI findings were correlated with revision surgery, endoscopy, and high-resolution manometry (HRM) as standard of reference. MRI was performed on a 3.0-T unit using T2-weighted half-Fourier acquisition single-shot turbo spin echo (HASTE) sequences for anatomical assessment of the GEJ followed by dynamic MR swallowing (fast low-angle shot sequences). Four independent readers (two radiologists, two surgeons) rated 83 MR scans according to defined criteria, such as wrap disruption, slipping, recurrent hiatal hernia, and esophageal motility disorder.ResultsWrap disruption was correctly diagnosed concordantly with the standard of reference in 87.8%, slipping in 81.5%, and recurrent hiatal hernia in 84.9% of the cases. For esophageal motility disorder, MRI interpretation was consistent with manometry in 66.2% of the subjects. Interobserver analysis showed substantial agreement for recurrent hiatal hernia (k = 0.703), moderate agreement for wrap disruption (k = 0.585), and fair agreement for motility disorder and slipping (k = 0.234 and k = 0.200, respectively).ConclusionMR swallowing readily depicts the major failure mechanisms of LARS and has good reliability even in non-experienced readers.Key Points• MR swallowing accurately readily depicts the major failure mechanisms of laparoscopic antireflux surgery and has good reliability even in non-experienced readers.• It should be included in the preoperative workup for revision surgery after fundoplication.• It will be of great benefit to surgeons in considering and planning a reoperation.
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44 schema:keywords Fourier acquisition single-shot turbo spin echo (HASTE) sequences
45 LARS
46 MR
47 MR scans
48 MR swallowing
49 MRI
50 MRI findings
51 MRI interpretation
52 MethodsIn
53 Nissen fundoplication
54 PurposeTo
55 ResultsWrap disruption
56 T2-weighted
57 acquisition single-shot turbo spin echo (HASTE) sequences
58 agreement
59 analysis
60 anatomical assessment
61 antireflux surgery
62 assessment
63 benefits
64 board-approved prospective study
65 care
66 cases
67 criteria
68 diagnostic performance
69 disorders
70 disruption
71 dynamic MR swallowing
72 echo sequence
73 endoscopy
74 esophageal motility disorders
75 evaluation
76 failure mechanisms
77 fair agreement
78 findings
79 fundoplication
80 gastroesophageal junction
81 gastroesophageal situs
82 good reliability
83 great benefit
84 hernia
85 hiatal hernia
86 high-resolution manometry
87 independent readers
88 institutional review board-approved prospective study
89 interobserver analysis
90 interpretation
91 junctions
92 laparoscopic Nissen fundoplication
93 laparoscopic antireflux surgery
94 major failure mechanisms
95 manometry
96 mechanism
97 method
98 moderate agreement
99 motility disorders
100 non-experienced reader
101 patients
102 performance
103 postoperative care
104 postoperative gastroesophageal situs
105 preoperative workup
106 prospective study
107 readers
108 recurrent hiatal hernia
109 reference
110 reliability
111 reliable method
112 reoperation
113 review board-approved prospective study
114 revision surgery
115 scans
116 sequence
117 single-shot turbo spin echo (HASTE) sequence
118 situs
119 slipping
120 spin echo sequence
121 standard of reference
122 standards
123 study
124 subjects
125 substantial agreement
126 surgeons
127 surgery
128 swallowing
129 symptomatic patients
130 turbo spin echo sequence
131 units
132 workup
133 wrap disruption
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