Imaging appearance of surgical sponges at 1.5 T MRI: an in vitro study

To predict the MR appearance of retained surgical textiles in the acute setting by using an in vitro phantom and body MR imaging protocols.

Three surgical sponges were embedded in clear gelatin. One of these sponges was soaked in fresh human blood and the other two sponges were embedded dry. The following sequences were acquired at 1.5 T: T1W 3D gradient echo with chemical shift saturation (VIBE, volumetric interpolated breath-hold examination), 3D gradient dual echo T1W (in and opposed phase), 2D T2W single shot fast spin echo (HASTE, half-fourier acquisition single shot turbo spin echo), and 3D T2W fast spin echo (SPACE, sampling perfection with application optimized contrast using different flip angle evolutions).

The radiopaque marker within the surgical sponge appears as a linear hypointense structure on T1W and T2W images. Slightly increased conspicuity of the radiopaque marker is seen on the in phase gradient dual echo images compared with the opposed phase gradient dual echo images, likely due to magnetic susceptibility effect. The surgical sponge material is invisible on the T1W images and appears hypointense on the T2W images. Owing to the T1W hyperintensity and T2W hypointensity of blood, the radiopaque marker within the blood soaked gauze is visible on the T1W images but obscured on the T2W images.

We describe the in vitro MR appearance of retained surgical sponges in order to simulate their appearance in the acute setting prior to the mass-like foreign body reaction which may occur in the chronic phase.