体格检查、超声及磁共振成像检测腹股沟疝与腹腔镜检查结果的比较
Detection of groin hernia with physical examination, ultrasound, and MRI compared with laparoscopic findings.
作者信息
van den Berg J C, de Valois J C, Go P M, Rosenbusch G
机构信息
Department of Radiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
出版信息
Invest Radiol. 1999 Dec;34(12):739-43. doi: 10.1097/00004424-199912000-00002.
OBJECTIVE
To determine the diagnostic accuracy of physical examination, ultrasound, and dynamic MRI in patients with inguinal hernia.
METHODS
In 41 patients with clinically evident herniations, 82 groins were evaluated using a standard ultrasound and MRI protocol, the latter including T1- and T2-weighted sequences as well as two dynamic sequences. All ultrasound examinations and MRI scans were reviewed without knowledge of clinical findings. In all cases, correlation with findings at laparoscopic surgery was made.
RESULTS
At surgery, 55 inguinal herniations were found. Physical examination revealed 42 herniations (one false-positive finding), whereas ultrasound made the diagnosis of a hernia in 56 cases (five false-positive and four false-negative findings). MRI diagnosed 53 herniations (one false-positive and three false-negative findings). Thus, sensitivity and specificity figures were 74.5% and 96.3% for physical examination, 92.7% and 81.5% for ultrasound, and 94.5% and 96.3% for MRI.
CONCLUSIONS
In patients with clinically uncertain herniations, MRI is a valid diagnostic tool with a high positive predictive value.
目的
确定体格检查、超声和动态磁共振成像（MRI）对腹股沟疝患者的诊断准确性。
方法
对41例临床诊断明显的疝患者，采用标准超声和MRI方案对82个腹股沟区进行评估，MRI包括T1加权和T2加权序列以及两个动态序列。所有超声检查和MRI扫描均在不知临床检查结果的情况下进行回顾。所有病例均与腹腔镜手术结果进行对照。
结果
手术中发现55例腹股沟疝。体格检查发现42例疝（1例假阳性结果），而超声诊断出56例疝（5例假阳性和4例假阴性结果）。MRI诊断出53例疝（1例假阳性和3例假阴性结果）。因此，体格检查的敏感性和特异性分别为74.5%和96.3%，超声为92.7%和81.5%，MRI为94.5%和96.3%。
结论
对于临床诊断不明确的疝患者，MRI是一种具有高阳性预测价值的有效诊断工具。
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