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- Does CT sinography increase foreign body detection?
C. Lopez-Jimenez, A. M. Morrissey, A. Groth, B. de la Puerta, K. C. L. Lee, C. R. Lamb
Background
This study evaluates the utility of computed tomography (CT) sinography for assessing draining tracts in small animals. Draining tracts, often linked to foreign bodies, pose diagnostic challenges. Traditional sinography involves contrast injection to map the tract. The study investigates whether CT sinography enhances the detection of tract extent or foreign bodies compared to standard CT.
Methods
The retrospective study included 27 dogs and one cat, with clinical records from two referral centers. CT sinography was performed after standard CT imaging. Imaging data included pre-contrast, post-intravenous (IV) contrast, and CT sinography. Outcomes were assessed by reviewing clinical improvements and surgical findings.
Results
CT sinography revealed a more extensive tract in 21% of cases and influenced case management in 11%. However, it did not significantly increase foreign body detection rates compared to standard CT (23% vs. 31%). Post-surgery, 46% of tracts resolved, while 21% recurred or persisted. In 57% of cases, no underlying cause was identified.
Limitations
The study was limited by its retrospective design and small sample size. Variability in imaging and catheter techniques may affect reproducibility. Also, not all cases underwent post-IV contrast CT, potentially limiting comparisons.
Conclusions
CT sinography offers modest additional diagnostic value over standard CT for draining tracts in small animals. Its primary utility lies in certain complex cases where the tract's extent may alter surgical planning. Further research with standardized protocols is needed to better establish its role in veterinary practice.
FIG 1. A 3-year old, female, Staffordshire bull terrier dog with history of chronic swelling. Example of CT signs of a flank sinus at the level of L5.
(A) Transverse pre-contrast image. (B) Transverse post-IV contrast image showing a cavitary lesion (small arrow), and swelling and heterogeneous
contrast enhancement of the epaxial and hypaxial muscles (between large arrows); these abnormalities are more clearly visible than in the precontrast image. (C) Transverse sinogram image showing a sinus tract that connects the cavity and muscle lesion; the tracts are more extensive than visualised in A and B
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