The MR appearance of vaginal fistulas.

Healy, J. C.; Phillips, Rachel R.; Reznek, Rodney H.; Crawford, Robin; Armstrong, Peter; Shepherd, John H.

doi:10.2214/ajr.167.6.8956582

Cited by 32 publications

(22 citation statements)

References 3 publications

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“…MRI is particularly helpful in depicting and delineating fistulas, with reported accuracy of 91% in vaginal fistulas. 78 The appearance of fistulas on MRI is best assessed on T 2 weighted images, where a fluid-filled fistula may be seen as a tract of high-signal intensity and an airfilled tract of low-signal intensity. The sagittal plane can be used to optimize localization of the fistula, assessing for disruption or discontinuity of the vaginal, bladder or rectal wall ( Figure 10).…”

Section: Treatment Of Vaginal Cancer Is Guided By the Figo Stage And mentioning

confidence: 99%

Primary vaginal cancer: role of MRI in diagnosis, staging and treatment

Gardner¹,

Jalan²,

Klopp³

et al. 2015

BJR

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Section: Treatment Of Vaginal Cancer Is Guided By the Figo Stage And mentioning

confidence: 99%

Primary vaginal cancer: role of MRI in diagnosis, staging and treatment

Gardner¹,

Jalan²,

Klopp³

et al. 2015

BJR

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“…After i.v. Gd injection, a fistulous tract mostly exhibits longitudinal central low signal intensity surrounded by a thin contrast-enhanced rim, its inflammatory wall [13,19]. Very small fistulae measuring < 3 mm may not clearly demonstrate the central T1WI low signal intense fistulous tract.…”

Section: Image Analysismentioning

confidence: 99%

Diagnostic performance of MRI for detection of intestinal fistulas in patients with complicated inflammatory bowel conditions

et al. 2007

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The diagnostic performance of magnetic resonance imaging (MRI) for detection of intestinal fistulas, other than perianal, in patients with known complicated inflammatory bowel conditions (CIBC) was investigated. Our study group consisted of 20 patients (12 women, mean age 43 years) with CIBC, including Crohn's disease (n=13), colonic diverticulitis (n=3), colitis after radiotherapy (n=3) and of postoperative origin (n=1). Eleven surgically proven enteral fistulas were known in ten (50%) of these patients, being of enterovesical (n=3), enterocolic (n=2), enteroenteral (n=2), rectovaginal (n=2), rectovaginovesical (n=1) and of entercutaneous (n=1) localisation. The other ten patients (50%), used as the control group, showed MR features of CIBC, although without any fistulous tract. Multiplanar T1-and T2-weighted sequences had been performed, including gadolinium-enhanced acquisition with fat saturation (1.5 T). MR findings were independently blindly and retrospectively reviewed by three radiologists for the presence and etiology of any fistula, as well as visualization and characterization of the fistulous tract. Results were compared with surgical findings (n=16) and clinical evolution (n=4). Interobserver agreement was calculated. Interobserver agreement kappa for fistula detection was 0.71. Overall sensitivity, specificity and accuracy for fistula detection were 78.6%, 75% and 77.2%, respectively. Sensitivity for fistula characterization was 80.6%, with visualization of the fistulous tract in all cases, whereby T1-weighted gadolinium-enhanced fat-saturated images were considered the most useful sequences. Gadolinium-enhanced MRI is a reliable and reproducible tool for detection of enteral fistulas secondary to inflammatory conditions.

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“…MR imaging also allowed a determination of the number of tracts in the fistula and, thus, its complexity. The single false-negative finding in this study was in a patient with an epithelialized tract that did not display high signal intensity on T2-weighted images (11).…”

Section: Ct Examinationmentioning

confidence: 55%

“…It affords optimal tracts (10,11). In our experience, certain pulse sequences provide optimal depiction of fistulas (11). The appearance of a fistula at MR imaging depends on whether it is filled with fluid, air, or a combination of the two.…”

Section: Teaching Pointmentioning

confidence: 95%

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Fistulas in Malignant Gynecologic Disease: Etiology, Imaging, and Management

Narayanan¹,

Nobbenhuis²,

Reynolds³

et al. 2009

RadioGraphics

108

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A fistula that occurs in association with a malignancy of the female reproductive tract may be caused by a primary or recurrent tumor or may be a complication of surgery or radiation therapy. Identification of the cause, complexity, and location of a fistula is essential for optimal management planning. Radiologic imaging, particularly with computed tomography and magnetic resonance techniques, is invaluable for the assessment of gynecologic fistulas and may help direct the clinician toward the most appropriate management pathway. The modality and technique selected for the initial imaging evaluation depend largely on the clinical history and manifestations. However, imaging with a combination of techniques often is required for accurate diagnosis and effective treatment planning. Radiologists should be familiar with suggestive clinical signs and symptoms as well as with the characteristic appearances of rectovaginal, vesicovaginal, ureterovaginal, enterovesical, enterocutaneous, and other pelvic fistulas at multimodality imaging.

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The MR appearance of vaginal fistulas.

Cited by 32 publications

References 3 publications

Primary vaginal cancer: role of MRI in diagnosis, staging and treatment

Primary vaginal cancer: role of MRI in diagnosis, staging and treatment

Diagnostic performance of MRI for detection of intestinal fistulas in patients with complicated inflammatory bowel conditions

Fistulas in Malignant Gynecologic Disease: Etiology, Imaging, and Management

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