Dallaudiere Benjamin, Sans Hugo, Reboul Gilles, Dallet Laurence, Reau Patricia, Bise Sylvain, Bouguennec Nicolas, Pesquer Lionel
Radiology, Clinique du Sport de Bordeaux Mérignac, Bordeaux, FRA.
Parietal Surgery, Clinique du Sport de Bordeaux Mérignac, Bordeaux, FRA.
Cureus. 2024 Mar 11;16(3):e55947. doi: 10.7759/cureus.55947. eCollection 2024 Mar.
Objective This study aimed to assess the performance of dynamic MRI in Chronic Groin Pain (CGP) related to the inguinal region, comparing it with surgery as the gold standard. Materials and methods A cohort of 25 consecutive patients exhibiting persistent clinical inguinal-related CGP underwent a pre-surgical pelvis MRI. Imaging encompassed strictly axial Fast Spin Echo (FSE) T1 sequences, both without (static sequence) and with Valsalva Maneuver (VM, dynamic sequence), alongside axial-oblique Proton Density weighted with Fat Saturation (PDFS). Evaluation of these sequences focused on identifying Abdominal Wall (AW) injuries. A consistent surgical approach was employed by the same surgeon across all patients (34 AW injuries in 25 patients). Specificity (Sp), Sensitivity (Se), Negative Predictive Value (NPV), Positive Predictive Value (PPV), and overall accuracy of MRI sequences and their combinations for detecting AW injuries were computed by comparing them to surgical findings. Results Ninety sequences were obtained, revealing that the axial PDFS oblique sequence emerged as the most singularly reliable (Accuracy: 58.82%). The optimal sequence combination was found to be axial T1 combined with axial T1 VM, exhibiting an accuracy of 75.00% (Se: 85.71%, Sp: 70.59%, PPV: 54.55%, NPV: 92.31%, with an average duration of 4 minutes and 31 seconds). Conclusion Based on our findings, we advocate for the adoption of the axial FSE T1 combined with Valsalva Maneuver as a dependable protocol for inguinal-related CGP, characterized by a highly reasonable examination duration.
目的 本研究旨在评估动态磁共振成像（MRI）在腹股沟区慢性腹股沟疼痛（CGP）中的表现，并与作为金标准的手术进行比较。材料与方法 连续25例表现为持续性临床腹股沟相关CGP的患者在术前接受了骨盆MRI检查。成像包括严格的轴向快速自旋回波（FSE）T1序列，包括无（静态序列）和有瓦尔萨尔瓦动作（VM，动态序列）的情况，以及轴向斜位脂肪饱和质子密度加权（PDFS）序列。这些序列的评估重点是识别腹壁（AW）损伤。所有患者均由同一位外科医生采用一致的手术方法（25例患者中有34处AW损伤）。通过将MRI序列及其组合与手术结果进行比较，计算其检测AW损伤的特异性（Sp）、敏感性（Se）、阴性预测值（NPV）、阳性预测值（PPV）和总体准确性。结果 共获得90个序列，结果显示轴向PDFS斜位序列是最可靠的单一序列（准确性：58.82%）。发现最佳序列组合为轴向T1与轴向T1 VM相结合，准确性为75.00%（Se：85.71%，Sp：70.59%，PPV：54.55%，NPV：92.31%，平均时长4分31秒）。结论 根据我们的研究结果，我们提倡采用轴向FSE T1结合瓦尔萨尔瓦动作作为腹股沟相关CGP的可靠检查方案，其检查时长非常合理。
