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

Abstract

Endoanal sonography is an accurate and noninvasive imaging modality for evaluation of fistulas. It is a very useful tool for preoperative management and surgical planning by providing precise and detailed information on fistulas.

Effects of preoperative endoanal ultrasound on functional outcome after anal fistula surgery

“…This may be due to anticipated sophisticated anatomy of the fistulas and the caution of current anal sphincter integrity. The concordance of EAUS and intraoperative findings in this study was 90.8% (99 in 109) which is comparable with previous studies 17 18 31…”

“…Sensitivity of EAUS for fistula detection is 0.87 (95% CI 0.70 to 0.95) which is considered comparable with MRI even with lower specificity of 0.43 (95% CI 0.21 to 0.69) 15. Higher sensitivity (92%) and specificity (100%) was found in more recent studies 27 31. For defining the fistula type and height, EAUS accuracy was 91% and 92%, respectively, with very good interobserver agreement 16.…”

Comparison of the Diagnostic Accuracy of Percutaneous Fistula Contrast-Enhanced Ultrasound Combined with Transrectal 360° 3-D Imaging and Conventional Transrectal Ultrasound in Complex Anal Fistula

“…Meanwhile, ultrasonography was recommended by the American Society of Colorectal Surgery as a routine method for pre-operative examination of anal fistula in 2011 because of its advantages of simple operation, low cost and repeatability (Steele et al 2011). The probes commonly used in ultrasound examination included high-frequency linear array probes, intracavity end-scan probes, rectal biplane probes and rectal 360˚ring scan probes (Siddiqui et al 2012;Luglio et al 2018;Sun et al 2018), and the diagnosis is made mainly by the combination of superficial and endo-anal ultrasonography. However, it could not be used to accurately identify some fistulas with large numbers, small diameters or complicated shapes.…”

Crohn’s disease at radiological imaging: focus on techniques and intestinal tract

“…89 On the other hand, US performed with and endocavitary approach (using endoanal or transvaginal probes) can give more detailed information on the deepest portion of the fistula. [90][91][92] Although both of the 2 evaluation methods can provide useful information, a combination of them would be ideal for an exhaustive assessment. Furthermore, vascular information pro- vided by color-Doppler can be useful in distinguishing active inflammation from fibrosis.…”

“…Furthermore, vascular information pro- vided by color-Doppler can be useful in distinguishing active inflammation from fibrosis. [90][91][92] According to recent recommendations, CTE and MRE must include the anal canal within the field of view to analyze any suspicion of a perianal involvement. 51 However, for the evaluation of the anal canal region, different and specific studies have to be obtained especially in view of future surgical management.…”