Detection of groin hernia with physical examination, ultrasound, and MRI compared with laparoscopic findings

OBJECTIVE. TO determine the diagnostic accuracy of physical examination, ul trasound, and dynamic MRT in patients with inguinal hernia. METHODS. In 41 patients with clinically evident herniations, 82 groins were evaluated using a standard ultrasound and MRT protocol, the latter includi ng T1- and T2-weighted sequences as well as two dynamic sequences. All ultr asound examinations and MRI scans were reviewed without knowledge of clinic al findings, In all cases, correlation with findings at laparoscopic surger y was made. RESULTS. At surgery, 55 inguinal herniations were found. Physical examinati on revealed 42 herniations (one false-positive finding), whereas ultrasound made the diagnosis of a hernia in 56 cases (five false-positive and four f alse-negative findings). MRI diagnosed 53 herniations (one false-positive a nd three false-negative findings). Thus, sensitivity and specificity figure s were 74.5% and 96.3% for physical examination, 92.7% and 81.5% for ultras ound, and 94.5% and 96.3% for MRI, CONCLUSIONS. In patients with clinically uncertain herniations, MRI is a va lid diagnostic tool with a high positive predictive value.