Imaging of the Abdominal Wall Sinus Tract: Comparison of Computed Tomography Sinography and X-Ray Sinography

Abstract

Objective: To clarify the comparative benefits of X-ray sinography and computed tomography (CT) sinography in assessing the abdominal wall sinus tract. Methods: In this cross-sectional study, patients in our hospital with an abdominal wall sinus tract who had received both X-ray sinography and CT sinography from January 2018 to January 2021 were enrolled. The intraoperative findings were used as the gold standard to calculate the accuracy of the two methods. Kappa statistic was employed to evaluate the concordance between the two methods and the intraoperative findings. Differences in diameters measured on X-ray sinography and CT sinography images were analyzed using the Wilcoxon signed rank test. Results: The study sample consisted of 74 patients. The accuracy of the CT sinography in diagnosing the extent of the sinus invasion was 85.1% while the accuracy of the X-ray sinography was 59.5%. For the sinus confined to the abdominal wall (Kappa: 0.783 VS 0.248), the sinus extending into the abdominal cavity (Kappa: 0.734 VS 0.339), and the sinus with fistula formation (Kappa: 0788 VS 0.496), the consistency of the CT sinography and surgery was significantly better than that of the X-ray sinography. Diameters of the sinus tract measured on CT images were statistically larger than the diameters measured on X-ray sinography (P<0.001). Conclusion: CT sinography has significant advantages to X-ray sinography in depicting the extent of the abdominal wall sinus tract and the presence of a fistula.