Skeletal Radiology

, Volume 47, Issue 5, pp 649–660 | Cite as

MRI in chronic groin pain: sequence diagnostic reliability compared to systematic surgical assessment

  • Emmanuel Ducouret
  • Gilles Reboul
  • François Dalmay
  • Christina Iosif
  • Charbel Mounayer
  • Lionel Pesquer
  • Benjamin Dallaudiere
Scientific Article



To determine the diagnostic reliability of magnetic resonance imaging (MRI) sequences in chronic groin pain (CGP) compared to surgery and try to propose a suitable MRI protocol.

Materials and methods

Forty-three consecutive patients with resistant clinical CGP underwent a pre-surgical pelvis MRI. Eight MRI sequences were acquired: axial fast spin-echo T1-weighted (FSE T1), coronal FSE T1, axial-oblique (in symphysis plane) proton density weighted with fat saturation (PDFS), coronal PDFS, sagittal PDFS, axial FSE T1 with fat saturation and gadolinium enhancement (FSGE), coronal FSE T1 FSGE and axial FSE T1 with Valsalva maneuver (VM). These sequences were reviewed for pubic symphysis assessment, adductor longus (AL) tendon and abdominal wall (AW) injuries. The same surgeon operated on all of these patients (26 AL and 49 AW). Sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative prospective value (NPV) and accuracy of each sequence and combinations for AL or AW injuries were calculated in comparison to surgical findings.


One hundred ninety-two sequences were obtained. Coronal T1 FSGE and axial T1 VM proved to be the most reliable sequences (accuracy: 91.67% in AL and 83.33% in AW). The best sequence combination was coronal T1, axial PDFS, sagittal PDFS and axial T1 VM (accuracy: 77.78%; Se: 100.00%, Sp: 69.23%, PPV: 55.56%, NPV: 100.00%).


MRI has 77.78% accuracy, 100.00% sensitivity, 69.23% specificity, 55.56% PPV and 100.00% NPV in evaluating CGP, with coronal T1-axial PDFS-sagittal PDFS-axial T1 VM as the optimal protocol in terms of diagnostic performance within a reasonable scan time. Diagnostic performance of MRI was examined in the evaluation of CGP using surgery as reference standard.


Chronic Groin pain MRI Sequences Reliability Protocol Surgery 


Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Supplementary material

256_2017_2824_MOESM1_ESM.docx (144 kb)
ESM 1 (DOCX 143 kb)
256_2017_2824_MOESM2_ESM.docx (134 kb)
ESM 2 (DOCX 134 kb)


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Copyright information

© ISS 2017

Authors and Affiliations

  • Emmanuel Ducouret
    • 1
  • Gilles Reboul
    • 2
  • François Dalmay
    • 3
  • Christina Iosif
    • 4
    • 5
  • Charbel Mounayer
    • 6
  • Lionel Pesquer
    • 7
  • Benjamin Dallaudiere
    • 7
    • 8
    • 9
  1. 1.Département de RadiologieCentre Hospitalier Universitaire DupuytrenLimogesFrance
  2. 2.Service de Chirurgie PariétaleClinique du Sport de Bordeaux-MérignacMérignacFrance
  3. 3.CEBIMERCentre Hospitalier Universitaire DupuytrenLimogesFrance
  4. 4.CHU Jean MinjozBesançonFrance
  5. 5.BioEM, CNRS, UMR 7252, Université de LimogesLimogesFrance
  6. 6.Département de Neuroradiologie InterventionnelleCentre Hospitalier Universitaire DupuytrenLimogesFrance
  7. 7.Centre d’imagerie ostéoarticulaireClinique du Sport, Bordeaux MérignacMérignacFrance
  8. 8.Service de Radiologie, Département d’imagerie Musculo-SquelettiqueCentre Hospitalier Universitaire PellegrinBordeauxFrance
  9. 9.Centre de Résonance Magnétique des Systèmes Biologiques, UMR 5536, CNRSUniversité de BordeauxBordeauxFrance

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