Fistula in ano: endoanal sonography versus endoanal MR imaging in classification.

Hussain, Shahid; Stoker, J.; Schouten, W. R.; Hop, Wim C. J.; Laméris, Johan S.

doi:10.1148/radiology.200.2.8685344

Cited by 151 publications

(126 citation statements)

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“…We used a STIR protocol for body coil imaging, rather than a fat-suppressed T2-weightedprotocol,becausewe found that it provides better anatomic detail for classifica tion, in agreementwith other investigators [21]. In contrast,in most published work relat ing to endoanalfistula imaging, a 12-weighted protocol was used [17,18] becauseit provides the best balance between highlighting sepsis and supplying adequate anatomic detail for classification. We initially used STIR se quences with theendoanal coil but soonaban donedit because lossof anatomicdetaildueto signal falloff was unacceptable.…”

Section: Mr Imaging Of Fistula In Anosupporting

confidence: 58%

“…Fistulographyis incorrect 84% of the time [5]. Endoanal sonography is unable to reveal sepsislying beyondthe focal rangeof the tram ducer [10,12,18], and CF cannot adequately reveal the sphincters or subtle infection [7,8].…”

Section: Mr Imaging Of Fistula In Anomentioning

confidence: 99%

“…However, accurateclassification usingthe bodycoil alreadyapproaches 100% [16], suggesting that more detailed imaging of the anal sphinctercomponentsis unnecessary. Furthermore, studies comparing endoanal MR imaging with surgical classification have found concordance to be only 64% [18].…”

Section: Mr Imaging Of Fistula In Anomentioning

confidence: 99%

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MR imaging of fistula in ano: are endoanal coils the gold standard?

Halligan¹,

Bartram²

1998

American Journal of Roentgenology

104

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OBJECTIVE. It hasbeen suggested that fistulain ano is mostaccuratelyassessed using endoanalreceivercoils becausethey providesuperiorspatialresolution.We aimed to deter mine their advantageby prospective comparisonwith conventional bodycoil imaging. SUBJECTS AND METHODS. Thirty consecutive unselectedpatientswith a diagnosis of anorectal sepsiswere examined by MR imaging with an endoanalcoil. Imaging with a body coil followed. Imaging was independently evaluatedby two radiologists who classified fistulas according to the coil used and then compared their findings, which were validated surgically.RESULTS. Five patientscouldnot toleratecoil insertion.In the remaining25 patients,en doanalimagingrevealedno abnormalitiesin threepatientsin whom the bodycoil imagecor rectly showed Crohn's disease, a sinus, and a transsphincteric fistula. Imaging with both coils revealedsepsisin 16patients, allowing radiologists to make correct primary track classification in 13patientson endoanal imagingcomparedwith 15patientson bodycoil imaging.Endoanal imagingrevealed10 secondaryextensionsin eight patients,but furtherextensionsin two of these patients and in a third patient were undetected.All theseextensions were seenon body coil imaging. Overall, surgical concordance was 68% for endoanal imaging compared with 96% for conventional bodycoil imaging.CONCLUSION. Due to field-of-view limitations,endoanalimagingis lessaccuratethan conventional body coil imaging for preoperative assessment of complex anal fistulas.

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Section: Mr Imaging Of Fistula In Anosupporting

confidence: 58%

Section: Mr Imaging Of Fistula In Anomentioning

confidence: 99%

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MR imaging of fistula in ano: are endoanal coils the gold standard?

Halligan¹,

Bartram²

1998

American Journal of Roentgenology

104

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“…According to our literature review, the accuracy of EAUS compared with surgery in the detection of the internal opening has varied between 28% and 94%, and the accuracy in the detection of the primary tract and secondary extension have been in the range of 36%-100% and 23%-92%, respectively [9][10][11][12] . Such a wide range of accuracy rates could be related to differences in the criteria used to identify the internal opening, differences in operator experience, and differences in the complexities of fistulae recruited.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional endoanal ultrasonographic assessment of an anal fistula with and without H₂O₂enhancement

Kim¹,

Park²

2009

WJG

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AIM:To evaluate the effectiveness of three-dimensional endoanal ultrasound (3D-EAUS) in the assessment of anal fistulae with and without H2O2 enhancement. METHODS:Sixty-one patients (37 males, aged 17-74 years) with anal fistulae, which were not simple low types, were evaluated by physical examination and 3D-EAUS with and without enhancement. Fistula classification was determined with each modality and compared to operative findings as the reference standard. RESULTS:The accuracy of 3D-EAUS was significantly higher than that of physical examination in detecting the primary tract (84.4% vs 68.7%, P = 0.037) and secondary extension (81.8% vs 62.1%, P = 0.01) and localizing the internal opening (84.2% vs 59.7%, P = 0.004). A contrast study with H2O2 detected several more fistula components including two primary suprasphincteric fistula tracks and one supralevator secondary extension, which were not detected on non-contrast study. However, there was no significant difference in accuracy between 3D-EAUS and H2O2-enhanced 3D-EAUS with respect to classification of the primary tract (84.4% vs 89.1%, P = 0.435) or secondary extension (81.8% vs 86.4%, P = 0.435) or localization of the internal opening (84.2% vs 89.5%, P = 0.406).CONCLUSION: 3D-EAUS was highly reliable in the diagnosis of an anal fistula. H2O2 enhancement was helpful at times and selective use in difficult cases may be economical and reliable.

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“…Endoluminal anal coils offer higher spatial resolution than body coils [32], and their use resulted in an initial increased accuracy of classification of the primary track to up to 93% [33,34]. However, examinations performed using endoanal coils alone are limited by field of view and by patient discomfort, a result of which is often suboptimal image quality due to patient motion [35].…”

Section: Mr Imaging Techniquesmentioning

confidence: 99%

MRI of Crohn?s Anoperineal Disease

McDermott¹

2013

J Gastrointest Dig Syst

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Anoperineal involvement is seen in up to 38% of patients with Crohn's disease. To adopt the best treatment strategy and avoid recurrences, it is important to obtain precise radiological information of the fistulous track. Magnetic resonance imaging provides precise information on the anatomy of the anal canal, the anal sphincteric complex, and the relationship of the fistula to the pelvic floor structures. In this article we review the anatomy of the anal canal, the pathogenesis of perianal fistula, different MRI sequences for the evaluation of fistula with emphasis on their imaging findings and an MR imaging based grading system for their classification.

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Fistula in ano: endoanal sonography versus endoanal MR imaging in classification.

Abstract: Endoanal MR imaging more accurately allows depiction and classification of fistula in ano than endoanal sonography.

Cited by 151 publications

References 0 publications

MR imaging of fistula in ano: are endoanal coils the gold standard?

MR imaging of fistula in ano: are endoanal coils the gold standard?

Three-dimensional endoanal ultrasonographic assessment of an anal fistula with and without H₂O₂enhancement

MRI of Crohn?s Anoperineal Disease

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Fistula in ano: endoanal sonography versus endoanal MR imaging in classification.

Abstract: Endoanal MR imaging more accurately allows depiction and classification of fistula in ano than endoanal sonography.

Cited by 151 publications

References 0 publications

MR imaging of fistula in ano: are endoanal coils the gold standard?

MR imaging of fistula in ano: are endoanal coils the gold standard?

Three-dimensional endoanal ultrasonographic assessment of an anal fistula with and without H2O2enhancement

MRI of Crohn?s Anoperineal Disease

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Product

Resources

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Three-dimensional endoanal ultrasonographic assessment of an anal fistula with and without H₂O₂enhancement