The application value of computed tomography and magnetic resonance imaging sinography/fistulography in evaluating chronic wounds: a prospective study

Background: Chronic wounds are a worldwide health problem, with traditional imaging techniques failing in their accurate evaluation. Therefore, an effective imaging evaluation method is needed for the diagnosis and treatment or chronic wounds. This study is to investigate the application value of computed tomography (CT) and magnetic resonance imaging (MRI) sinography/fistulography in assessing the morphology and deep features of chronic wounds. Methods: We prospectively enrolled 43 chronic wounds patients who received both CT and MRI sinography/fistulography. The morphology and deep features of chronic wound on CT and MRI images were independently evaluated by 2 experienced radiologists. Kappa value and intraclass correlation coefficient (ICC) were calculated to evaluate the interobserver agreement and the consistency between CT and MRI sinography/fistulography in assessing the shape, number of branches, and involvement of body cavity and bones of chronic wounds. Results: There were substantial to almost perfect interobserver agreements for both CT and MRI sinography/fistulography in evaluating the morphology and deep features of chronic wounds. The consistency between CT and MRI was almost perfect for the 2 readers in evaluating the shape (reader 1, kappa value =1.000; reader 2, kappa value =0.932) and the number of branches [reader 1, ICC =0.951 (95% confidence interval: 0.909-0.973, P<0.001); reader 2, ICC =0.874 (95% confidence interval: 0.768-0.932, P<0.001)], and substantial to almost perfect when evaluating the involvement of body cavity (reader 1, kappa value =0.728; reader 2, kappa value=0.775) and bones (reader 1, kappa value=0.659; reader 2, kappa value =0.860). Conclusions: There was good interobserver agreement and consistency between CT and MRI sinography/ fistulography in evaluating the morphology and deep features of chronic wounds.