Efficacy of Ultrasound Compared to Magnetic Resonance Imaging for the Preoperative Mapping of Pilonidal Sinus Disease: A Proof of Concept Study.

IF 1.6 4区医学 Q3 SURGERY

Surgical Innovation Pub Date : 2025-10-15 DOI:10.1177/15533506251387881

Nicolas De Hous, Eline De Smet, Frederik Bosmans, Maarten Spinhoven, Tom Hendrickx, Marie Gaillard, Sylvie Van den Broeck, Niels Komen

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引用次数: 0

Abstract

BackgroundRecurrence of pilonidal sinus disease (PSD) after minimally invasive surgery remains a significant challenge to surgeons and may be explained by incomplete obliteration of the sinus. Preoperative imaging could play an important role in addressing this problem. Magnetic resonance imaging (MRI) is considered the modality of choice but is costly and time-consuming. The objective of this study was to determine if ultrasound (US) is a feasible alternative to MRI in preoperative PSD mapping.MethodsA prospective, proof of concept study was conducted on patients treated with laser ablation in 2 Belgian hospitals between Jan 2023 and Dec 2024. The patients underwent a preoperative US and MRI. Sinus characteristics were described according to a predefined protocol. The agreement between US and MRI was quantified using the intraclass correlation coefficient (ICC) for the measurement of 3 sinus dimensions (length, depth and width) and Cohen's kappa coefficient (k) for the detection of side branches.Results30 patients were included with a median age of 27 years (IQR 20-35). Median sinus dimensions were 3.3 cm (IQR 1.5-5.6), 0.5 cm (IQR 0.3-0.8) and 0.7 cm (IQR 0.4-1.2) on US, and 1.9 cm (IQR 1.5-3.9), 0.4 cm (IQR 0.2-0.6) and 0.4 cm (IQR 0.2-0.7) on MRI for length, depth and width respectively. Side branches were detected in 6 (22%) patients on US and in ten (40%) patients on MRI. The level of agreement between US and MRI was moderate for sinus length (ICC 0.74, 95% CI 0.49-0.87, P < 0.001), and poor for sinus depth (ICC 0.30, 95% CI -0.05-0.60, P = .041) and width (ICC 0.36, 95% CI -0.03-0.66, P = .008). The level of agreement for the detection of side branches was moderate (k 0.46, 95% CI 0.11-0.82, P = .013).ConclusionPreoperative US is not suitable for the preoperative mapping of PSD when compared to MRI. MRI remains the preferred imaging technique in our clinical practice especially for complex PSD.

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超声与磁共振成像在术前定位毛毛窦疾病中的疗效：概念验证研究。

背景：微创手术后毛突窦疾病（PSD）的复发仍然是外科医生面临的一个重大挑战，可能是由于窦的不完全闭塞。术前影像学在解决这一问题方面发挥着重要作用。磁共振成像（MRI）被认为是选择的方式，但昂贵和耗时。本研究的目的是确定超声（US）是否是一种可行的替代MRI术前PSD定位。方法对2023年1月至2024年12月在比利时2家医院接受激光消融治疗的患者进行前瞻性概念验证研究。患者术前行超声和核磁共振检查。根据预先确定的方案描述鼻窦特征。使用类内相关系数（ICC）测量3个鼻窦尺寸（长度、深度和宽度）和Cohen’s kappa系数(k)检测侧支来量化US和MRI之间的一致性。结果入选患者30例，中位年龄27岁（IQR 20 ~ 35岁）。超声成像中窦尺寸分别为3.3 cm （IQR 1.5-5.6）、0.5 cm （IQR 0.3-0.8）和0.7 cm (IQR 0.4-1.2)， MRI上长、深、宽分别为1.9 cm （IQR 1.5-3.9）、0.4 cm （IQR 0.2-0.6）和0.4 cm （IQR 0.2-0.7）。6例（22%）患者在超声检查中发现侧支，10例（40%）患者在MRI检查中发现侧支。US和MRI对鼻窦长度的一致性中等（ICC 0.74, 95% CI 0.49-0.87, P < 0.001），而对鼻窦深度（ICC 0.30, 95% CI -0.05-0.60, P = 0.041）和宽度（ICC 0.36, 95% CI -0.03-0.66, P = 0.008）的一致性较差。侧支检测的一致性水平为中等（k = 0.46, 95% CI = 0.11-0.82, P = 0.013）。结论术前超声与MRI相比，不适合用于PSD的术前定位。MRI仍然是我们临床实践中首选的成像技术，特别是对于复杂的PSD。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical Innovation 医学-外科

CiteScore

2.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Surgical Innovation (SRI) is a peer-reviewed bi-monthly journal focusing on minimally invasive surgical techniques, new instruments such as laparoscopes and endoscopes, and new technologies. SRI prepares surgeons to think and work in "the operating room of the future" through learning new techniques, understanding and adapting to new technologies, maintaining surgical competencies, and applying surgical outcomes data to their practices. This journal is a member of the Committee on Publication Ethics (COPE).