Usefulness of magnetic resonance imaging for diagnosing deep anorectal abscesses

Maruyama, Ryo; Noguchi, Tsuyoshi; Takano, Masahiro; Takagi, Koichi; Morita, Norikazu; Kikuchi, Ryuichi; Uchida, Yuzo

doi:10.1007/bf02237218

Cited by 24 publications

(7 citation statements)

References 12 publications

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“…8 Clinical examinations in several other conditions in the perineum, such as anorectal abscesses and fistulas, as well as urological diseases also have been compared with other investigations such as magnetic resonance imaging or ultrasound. [17][18][19] These data tell that a well-performed clinical examination can reach far but that you get some extra information from further investigations.…”

Section: Discussionmentioning

confidence: 98%

The Accuracy of Clinical Examination in the Diagnosis of Rectal Intussusception

Karlbom¹,

Graf²,

Nilsson³

et al. 2004

Diseases of the Colon &Amp; Rectum

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Section: Discussionmentioning

confidence: 98%

The Accuracy of Clinical Examination in the Diagnosis of Rectal Intussusception

Karlbom¹,

Graf²,

Nilsson³

et al. 2004

Diseases of the Colon &Amp; Rectum

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“…Maruyama et al . ( 26 ) suggested a similar explanation. From the practical point of view, an error of this type has no serious clinical implications since the technique of surgical treatment applied in all these fistula types is identical.…”

Section: Discussionmentioning

confidence: 81%

Porównanie badania endosonograficznego i rezonansu magnetycznego w diagnostyce wysokich przetok odbytu

Sudoł‐Szopińska

Kucharczyk²,

Kołodziejczak³

et al. 2014

J Ultrason

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Anal fistula is a benign inflammatory disease with unclear etiology which develops in approximately 10 in 100 000 adult patients. Surgical treatment of fistulae is associated with a risk of damaging anal sphincters. This usually happens in treating high fistulae, branched fistulae, and anterior ones in females. In preoperative diagnosis of anal fistulae, endosonography and magnetic resonance imaging play a significant role in planning the surgical technique. The majority of fistulae are diagnosed in endosonography, but magnetic resonance is performed when the presence of high fistulae, particularly branched ones, and recurrent is suspected.The aim of this paperThe aim of this paper was to compare the roles of the two examinations in preoperative assessment of high anal fistulae.Material and methodsThe results of endosonographic and magnetic resonance examinations performed in 2011–2012 in 14 patients (4 women and 10 men) with high anal fistulae diagnosed intraoperatively were subject to a retrospective analysis. The patients were aged from 23 to 66 (mean 47). The endosonographic examinations were performed with the use of a BK Medical Pro Focus system with endorectal 3D transducers with the frequency of 16 MHz. The magnetic resonance scans were performed using a Siemens Avanto 1.5 T scanner with a surface coil in T1, T1FS, FLAIR, T2 sequences and in T1 following contrast medium administration. The sensitivity and specificity of endosonography and magnetic resonance imaging were analyzed. A surgical treatment served as a method for verification. The agreement of each method with the surgery and the agreement of endosonography and magnetic resonance imaging were compared in terms of the assessment of the fistula type, localization of its internal opening and branches. The agreement level was determined based on the percentage of consistent assessments and Cohen's coefficient of agreement, κ. The integrity of the anal sphincters was assessed in each case.ResultsIn determining the fistula type, magnetic resonance imaging agreed with intraoperative assessment in 79% of cases, and endosonography in 64% of cases. Endosonography agreed with magnetic resonance in 57% of cases. In the assessment of internal opening, the agreement between endosonography and intraoperative assessment was 65%, between magnetic resonance and intraoperative assessment – 41% and between endosonography and magnetic resonance – 53%. In the assessment of fistula branches, endosonography agreed with intraoperative assessment in 67% of cases, magnetic resonance in 87% of cases, and the agreement between the two methods tested was 67%.ConclusionsMagnetic resonance is a more accurate method than endosonography in determining the type of high fistulae and the presence of branches. In assessing the internal opening, endosonography proved more accurate. The agreement between the two methods ranges from 53–67%; the highest level of agreement was noted for the assessment of branching.

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“…At present, its use as a diagnostic tool in the emergency situation in complex or high abscesses has been recommended because it is easy to perform and can be used in the operating room to assist in puncturing the abscess [15,16]. Magnetic resonance imaging has also been used in the assessment of deep pelvirectal and supralevator abscesses with good results [17], but it is not available in many institutions. In our series, endoanal ultrasound was helpful in cases of high intersphincteric abscesses, especially in recurrent cases.…”

Section: Discussionmentioning

confidence: 99%

Management of intersphincteric abscesses

et al. 2006

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Low intersphincteric abscesses should be treated by de-roofing of the abscess and division of the internal sphincter up to a level of the dentate line. High intersphincteric abscesses are relatively frequent and mostly require staged surgery with a temporary mushroom (de Pezzer) catheter. Accurate anatomical ultrasound localization and proper drainage become important to avoid recurrences or extrasphincteric fistulas.

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Usefulness of magnetic resonance imaging for diagnosing deep anorectal abscesses

Abstract: Magnetic resonance imaging was useful for diagnosing and differentiating ischiorectal and pelvirectal abscesses.

Cited by 24 publications

References 12 publications

The Accuracy of Clinical Examination in the Diagnosis of Rectal Intussusception

The Accuracy of Clinical Examination in the Diagnosis of Rectal Intussusception

Porównanie badania endosonograficznego i rezonansu magnetycznego w diagnostyce wysokich przetok odbytu

Management of intersphincteric abscesses

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