Comparative study of MRI fistulogram and X-ray fistulography with operative findings: in fistula in ano

Tripathi, Nishant; Chavan, Shahaji; Bendre, Mahendra; Sharma, Vishal

doi:10.18203/2349-2902.isj20191894

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…Further, it may create a wrong impression of the presence of an extrasphincteric track. The fourth important drawback is that fistulography is an invasive technique and may result in dissemination of sepsis [3,10].…”

Section: X-ray Fistulographymentioning

confidence: 99%

Current imaging techniques for evaluation of fistula in ano: a review

Sharma

Yadav

Sahu

et al. 2020

Egypt J Radiol Nucl Med

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Background: Fistula in ano is one of the common anorectal disorders which have a tendency to recur specially in complex cases usually due to missed or undetected sepsis at the time of examination or surgery. A correct identification of the primary source of crypt infection along with a complete understanding of the anatomical course of primary and secondary tracks and abscesses is a prerequisite for the successful management of fistula. Preoperative evaluation of fistula in ano using radio-imaging techniques provides a handy insight of fistula anatomy and helps in planning the appropriate treatment strategy. The objective of this article is to review the role of different radio-imaging techniques in the diagnosis and evaluation of fistula in ano along with their advantages and disadvantages over one another. Main text: A comprehensive literature review was performed searching through the electronic databases as well as the standard textbooks of colorectal surgery. X-rays (plain radiographs and contrast fistulography), computed tomography (CT) scanning, anal endosonography, and magnetic resonance (MR) imaging are the modalities used for preoperative imaging of fistula in ano. Due to low accuracy, X-ray fistulography is not used now for fistula imaging. CT fistulography can be more accurate in cases associated with acute inflammations and abscesses and the fistulas related with inflammatory bowel disease. Anal endosonography and MRI are two of the mostly used and reliable imaging techniques for fistula in ano. Though the use of a 3D technology has improved the accuracy of anal endosonography, MRI is the preferred choice by many. However, various reports have depicted comparable accuracies for both MRI and anal endosonography showing both to be equally sensitive but MRI to be more specific. 3D endoanal ultrasound, on the other hand, is more rapid and can also be used intraoperatively to provide live imaging during surgical exploration. Conclusion: Complex and recurrent fistula cases should undergo a preoperative imaging to reduce the chances of recurrence. MRI is recommended as the imaging modality of choice for such cases. 3D anal endosonography may however be a good option over MRI owing to its rapidity, availability, and potential of intraoperative assistance during surgery.

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Section: X-ray Fistulographymentioning

confidence: 99%

Current imaging techniques for evaluation of fistula in ano: a review

Sharma

Yadav

Sahu

et al. 2020

Egypt J Radiol Nucl Med

View full text Add to dashboard Cite

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“…In another study, both MRI and X-ray fistulography findings done in two separate groups of patients were compared with the surgical findings and found near 100% sensitivity of MRI, while that of X-ray fistulography was very low. 15 Sofic et al compared the findings of X-Ray, computed tomography (CT), and MRI fistulography in 24 cases and found transphincteric fistulae to be the most common (29.16%); intersphincteric (25%), recto-vaginal (25%), extrasphincteric (12.5%), suprasphincteric (8.33%), and abscess collections were seen in (16.6%) patients. The authors found the accuracy of the classification of fistulas on X-ray fistulography to be 37.5%, CT fistulography 50%, and MRI 83.3%.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging of Perianal Fistulas in Clinically Symptomatic Patients and the Correlation Among Plain, Contrast, and Post Jelly MRI Fistulography

Gupta

Kumar

et al. 2021

Journal of Coloproctology

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Objectives To evaluate different types of perianal fistulas and their complications on magnetic resonance imaging (MRI) and to compare plain, contrast, and jelly magnetic resonance fistulography findings. Materials and Methods This prospective study was performed in 30 patients who presented with perianal pus discharge or external fistulous opening. Magnetic resonance imaging of the perianal region before and after giving intravenous contrast and after injecting jelly through a percutaneous opening was performed on a 3T scanner and the results were correlated. Results The mean age of the patients was 40.13 ± 13.88 years (range 19–75 years). The male to female ratio was 14:1. The most common type of fistula was St. James classification type I, which was seen in 13 patients (43%), followed by type IV in 30%, type III in 16%, type II in 6.66%, and type V in 3.33% of the patients. Using agreement analysis, we compared the number of primary and secondary tracts, internal openings, and horseshoe tracts and found a significant agreement between plain and post Jelly MRI fistulography (kappa statistic close to 1). When comparing plain and contrast MRI, there was significant agreement in the primary and secondary tracts, while statistically insignificant results were obtained (p > 0.05) for the horseshoe tract and internal openings. Contrast injection was helpful in 7 subjects (23.3%) as peripheral enhancement of abscesses were better delineated. Conclusion Magnetic resonance imaging is the one stop diagnostic modality for perianal fistulas. Acquisition of axial (Ax) T2, axial T2 FS, coronal T2 and coronal T2 FS sequences without administering intravenous contrast or jelly is usually sufficient for the diagnosis of fistulas and their complications.

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Comparative study of MRI fistulogram and X-ray fistulography with operative findings: in fistula in ano

Cited by 2 publications

References 9 publications

Current imaging techniques for evaluation of fistula in ano: a review

Current imaging techniques for evaluation of fistula in ano: a review

Magnetic Resonance Imaging of Perianal Fistulas in Clinically Symptomatic Patients and the Correlation Among Plain, Contrast, and Post Jelly MRI Fistulography

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