Magnetic resonance imaging in the diagnosis for predictors of ventral hernia recurrence

Abstract

Introduction: The problem of surgical treatment of patients with ventral hernias remains actual over years. This is due to significant number of patients with this pathology as well as a steadily high percentage of recurrence of the disease after reconstructive operations (24%–44%).

Aim: To identify the interrelation between the constitutional peculiarities of patients and the condition of the anterior abdominal wall tissues as predictors of the formation and recurrence of ventral hernias, based on the results of magnetic-resonance study.

Materials and methods: To assess the connection between the body constitution, the age and the morphological structure of the anterior abdominal wall, we examined 71 patients who were referred for magnetic-resonance examination of the abdominal cavity. In the work, the age of the patients was defined (WHO classification (2015)), and the body mass index. To reveal the signs of undifferentiated connective tissue dysplasia (CTD), the chart by T. Milkovska–Dmitrova and A. Karkashev (1985) was used. For statistical processing of the data and construction of the graph, Statistica 13.3, SPSS 14.0 for Windows Evaluation Version, MS Excel 2016 statistic packages were used.

Results:  Fatty degeneration of muscle tissue (DMT) prevails among elder individuals (r_xy=-0.540; p< 0.05). Obesity is accompanied by diastasis of abdominal rectus muscles (r_xy=0.806, p< 0.05) and fatty degeneration (r_xy=0.568; p< 0.05). Connective tissue dysplasia is closely associated with the rectus muscle diastasis (rxy=0.948; t_Ст=3.834; p< 0.05) and distension of the umbilical ring (r_xy=0.934; T-test=3.703, p< 0.05). Latent aponeurosis defects are also most characteristic of patients with connective tissue dysplasia; however, this dependence was not statistically confirmed in the studied cohort (r_xy=0.258; T-test=0.734, p> 0.05).

Conclusion: Вefore planning surgical intervention for ventral hernia, we recommend MRI examination of the anterior abdominal wall tissues be performed in patients for determination of the volume of the intervention to prevent recurrence.

Keywords

Magnetic resonance imaging / MRI / ventral hernia / recurrence / predictors

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