3D-EAUS and MRI in the Activity of Anal Fistulas in Crohn’s Disease

Abstract

Aim. This study aspires to assess the role of 3D-Endoanal Ultrasound (3D-EAUS) and Magnetic Resonance Imaging (MRI) in preoperative evaluation of the primary tract and internal opening of perianal fistulas, of secondary extensions and abscess. Methods. During 2014, 51 Crohn's disease patients suspected for perianal fistula were enrolled. All patients underwent physical examination with both the methods and subsequent surgery. Results. In the evaluation of CD perianal fistulas, there are no significant differences between 3D-EAUS and MRI in the identification of abscess and secondary extension. Considering the location, 3D-EAUS was more accurate than MRI in the detection of intersphincteric fistulas (p value = 10−6); conversely, MRI was more accurate than 3D-EAUS in the detection of suprasphincteric fistulas (p value = 0.0327) and extrasphincteric fistulas (p value = 4 ⊕ 10−6); there was no significant difference between MRI and 3D-EAUS in the detection of transsphincteric fistulas. Conclusions. Both 3D-EAUS and MRI have a crucial role in the evaluation and detection of CD perianal fistulas. 3D-EAUS was preferable to MRI in the detection of intersphincteric fistulas; conversely, in the evaluation of suprasphincteric and extrasphincteric fistulas the MRI was preferable to 3D-EAUS.

Three‐dimensional endoanal ultrasound is accurate and reproducible in determining type and height of anal fistulas

“…Moreover, 3D‐EAUS was not compared to other imaging modalities (2D‐EAUS and/or MRI). However, many excellent comparative studies have already been published and consequently our aims were focused on the evaluation of the accuracy and reproducibility of 3D‐EAUS in the definition of fistula type and height . Our results correlated well and were consistent with the current literature .…”

Radiological assessment of anal cancer: an overview and update

“…3 ), of the intersphincteric plane, and of the position of the anal verge, essential for planning surgical approach. 3D-EAUS is the first investigation in benign anal diseases [ 17 ]. As showed by Alabiso et al [ 17 ] it is a diagnostic method able to identify the intersphincteric or submucosal lesion, depicting the intersphincteric plane and both the internal and external sphincters, whose identification is critical to the proper patients management [ 12 ]: to identify a T1 lesion allows conservative management with sphincter sparing.…”

Perianal fistula imaging: a comparison between two-channel superficial Flex coil and eight-channel body coil

“…Anal endosonography is superior to clinical examination [27], but it has an inadequate field of view (FOV) and poor patient tolerance. Alabiso et al compared the performances of 3D-endoanal ultrasonography and MRI in the perianal fistulas of patients with Crohn's disease [28]. In their study, they proposed that MRI was preferable for the detection of supra-and extra-sphincteric fistulas and 3D-USG was preferable in the evaluation of inter-sphincteric fistulas.…”