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True-FISP MRI in diagnosis of postoperative hernia recurrence: a brief report
U Salati1, E Mansour, W Torreggiani
1Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland, umersalati@gmail.com.
Background:
A 24-year-old man underwent laparoscopic mesh repair of a right direct inguinal hernia which had recurred after previous surgery 3 months previously. A large swelling was noted in the right groin 4 h postoperatively, which was reduced initially but recurred within 24 h. A differential diagnosis of postoperative recurrence versus hematoma was considered, and patient was referred for imaging.
Methods:
The patient was imaged using different modalities including B-mode ultrasonography, computed tomography (CT) of the pelvis, and True-FISP magnetic resonance imaging (true imaging with steady-state precession MRI).
Results:
Initial focused ultrasound (US) [corrected] was suggestive of but equivocal for recurrence. Subsequent non-contrast CT of the region followed by rapid sequence (true-FISP) MRI confirmed the presence of bowel in the inguinal canal.
Conclusion:
Imaging has a role in the diagnosis of postoperative hernia recurrence in cases where there is a clinical diagnostic dilemma, especially MRI using true-FISP sequence, which is acquired in seconds, is a non-ionising radiation modality and does not have inter operator variability.
