Magnetic resonance imaging in perianal fistulas—A pictorial atlas

Sharma, Gururaj; Khandige, Ganesh; Mohan, Manjit

doi:10.1007/s12664-016-0688-2

Cited by 9 publications

(5 citation statements)

References 15 publications

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“…It has substantial morbidity and often requires multiple surgical treatments because of its high recurrence tendency. Surgical treatment of perianal fistulas continues to be a challenge for surgeons . A comprehensive preoperative evaluation of an anal fistula is important for adopting the best surgical strategy and avoiding recurrences.…”

mentioning

confidence: 99%

Utility of 360° Real‐time Endoanal Sonography for Evaluation of Perianal Fistulas

Sun

Cui

Liu

et al. 2017

J of Ultrasound Medicine

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mentioning

confidence: 99%

Utility of 360° Real‐time Endoanal Sonography for Evaluation of Perianal Fistulas

Sun

Cui

Liu

et al. 2017

J of Ultrasound Medicine

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“…Magnetic resonance (MR) is extremely useful in these cases thanks to its capability to provide precise anal canal anatomy and the relation of the stula to perineal structures. It allows precise de nition of the stulous track and identi cation of secondary stulas or abscesses, helping the surgeons avoid side effects (such as fecal incontinence) and decrease the incidence of recurrence [9,10].…”

Section: Introductionmentioning

confidence: 99%

Preoperative magnetic resonance imaging of anal fistulas with scrotal extension

Nguyen

et al. 2023

Preprint

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The aim of this study was to elucidate the magnetic resonance (MR) characteristics of anal fistulas extending to the scrotum, the rules applicable to them, and to correlate MR features with surgical findings. We conducted a retrospective study in 150 consecutive patients with anal fistulas extending into the scrotum, who were diagnosed and underwent surgery at University Medical Center Ho Chi Minh City between January 2017 and April 2022. MR findings were evaluated and compared with surgical findings using the Cohen’s kappa coefficient (k) with a 95% confidence interval. 150 patients (mean age 37.6 ± 10.9 years) with 166 fistulas, including 150 anal fistulas with scrotal extension. Most fistulas were low transsphincteric (80.0%, 120/150 patients). There was strong agreement for primary tract classification and detecting the location of internal openings between MRI and surgical findings with k = 0.83 (0.78–0.87) and k = 0.89 (0.85 – 0.93) (p<0.001), respectively. There is a significant correlation between the location of internal openings and the type of fistula (p<0.05). Low transsphincteric fistulas were predominant in the anterior group (103/122 patients vs. 10/19 patients), while in the posterior group it was more common in the high transsphincteric fistulas (7/19 patients vs. 14/122 patients), and the intersphincteric fistulas (1/19 patients vs. 5/122 patients); and the suprasphincteric fistulas were only seen in posterior group (1 patient). Anal fistulas with scrotal extension are exceptions to Goodsall’s rule. Albeit being long-tract fistulas, most of them are low transsphincteric and have anterior internal openings.

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“…Perianal anatomy is best evaluated using the 2D T1WI sequence, whereas a fistula or abscess is best evaluated using the 2D T2WI and 2D T1WI postcontrast sequence. 5 There are still many things that need to be improved in conventional MRI sequences. Because of their secretive-filled nature, perianal fistulas and perianal structures demonstrate strong signals in non-fat T2WI, resulting in poor image contrast and risking a poor diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Contrast-Enhanced 3D Imaging with 2D Imaging in the Evaluation of Perianal Fistula at 3T: A Prospective Observational Study

KV,

Arunachalam,

Sherene

et al. 2023

Indian J Radiol Imaging

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Introduction Perianal fistula and its recurrence is a challenging entity for surgeons. It is a well-establi1shed fact that magnetic resonance imaging (MRI) findings influence surgical procedures and reduce the rate of recurrence. In this study, we assessed the contrast-enhanced (CE) three dimensional T1 sequences [sampling perfection with application optimized contrast using different flip angle evolution (SPACE) and volumetric interpolated breath-hold examination (VIBE)] in a 3T MRI system to evaluate perianal fistulas and compared them with two-dimensional (2D) sequences. Materials and Methods Forty-four patients (mean age, 38.8 ± 15.3 [standard deviation]; 32 males, 12 females) with perianal fistula were included in this prospective study. The patients underwent conventional noncontrast, 2D sequences, diffusion-weighted imaging, followed by postcontrast, 2D T1 images in both axial and coronal planes, and 3D sequences at 3T. Acquisition times were recorded for each sequence. Each postcontrast sequence was evaluated in terms of image quality, presence of artifacts, fistula type, presence of an abscess, visibility, and number of internal orifices. The surgical findings were considered the gold standard. The imaging findings were compared with the surgical findings. Results In all three sequences, the fistula type and abscess were identified correctly in all patients. The sensitivity value for identification of ramifications utilizing CE 3D T1 VIBE sequence, CE 3D T1 SPACE, and CE 2D T1 images was 100, 86, and 36%, respectively. The number of internal orifices was identified by the CE 3D T1 VIBE and CE 3D T1 SPACE sequences in 100 and 92% of patients, respectively. CE 2D T1 images correctly identified internal orifices in 80% of patients. The overall scan time for each 3D sequence was shorter than for the combined postcontrast 2D sequences. Conclusion CE 3D T1 SPACE and CE 3D T1 VIBE sequences outperformed conventional CE 2D sequences in the evaluation of perianal fistulas in terms of visibility and the number of internal orifices with a shorter scanning time. Among the 3D sequences, CE 3D T1 VIBE is slightly superior to CE 3D T1 SPACE sequence.

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Magnetic resonance imaging in perianal fistulas—A pictorial atlas

Cited by 9 publications

References 15 publications

Utility of 360° Real‐time Endoanal Sonography for Evaluation of Perianal Fistulas

Utility of 360° Real‐time Endoanal Sonography for Evaluation of Perianal Fistulas

Preoperative magnetic resonance imaging of anal fistulas with scrotal extension

Comparison of Contrast-Enhanced 3D Imaging with 2D Imaging in the Evaluation of Perianal Fistula at 3T: A Prospective Observational Study

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