Magnetic resonance imaging findings in patients with initial manifestations of perianal fistulas

Waheed, Khawaja Bilal; Shah, Waseem Jan; Altaf, Bilal; Amjad, Muhammad; Hameed, Fawad; Wasim, Sana; UlHassan, Muhammad Zia; Abuabdullah, Zahra Mohammed; Rajamonickam, Selvin Nesaraj; Arulanatham, Zechriah Jebakumar

doi:10.5144/0256-4947.2020.42

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…Waheed’s study suggests that a complex or high perianal fistula on MRI images may be the initial presentation of CD, which differs from the general population [ 34 ]. By analyzing our patients, we found that 61.0% (83/136) presented with complex fistulas, whereas high fistulas were uncommon, only 8.1% (11/136).…”

Section: Discussionmentioning

confidence: 99%

The relationship between perianal fistula activity and abdominal adipose tissue in Crohn’s disease: an observational study

et al. 2022

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Objective The aim of this study was to analyze the relationship between abdominal adipose tissue and perianal fistula activity in patients with Crohn's disease (CD) using cross-sectional imaging. Methods Patients with perianal fistulizing CD who underwent pelvic magnetic resonance imaging (MRI) and abdominal computed tomography (CT) were retrospectively enrolled. We scored the fistulas in each patient's MRI images based on Van Assche's classification. The area and density of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) (at the third, fourth, and fifth lumbar (L3, L4, and L5) levels were measured by averaging five slices of measurements at each vertebral level in CT images, and areas were further standardized by the lumbar height2 (heightL1-5). The VAT/SAT ratio (VSR) and VAT/Total adipose tissue (VA/TA) index were calculated. Based on MRI scores, patients were divided into two groups with low and high activity, and their clinical, MRI features, and CT parameters were compared. We evaluated patients with follow-up MRI and compared the differences in clinical and radiological indicators among patients with different outcomes. Results Overall, 136 patients were included, 77 in the low-activity group and 59 in the high-activity group. Patients in the high activity group had lower subcutaneous adipose index (all levels, p < 0.05) and visceral adipose index (L3 level, p < 0.01), but higher SAT and VAT density (all levels, p < 0.01), VSR (L5 level, p = 0.07) and VA/TA index (L5 level, p < 0.05). Conclusion There were differences in adipose tissue composition among CD patients with different active perianal fistulas.

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Section: Discussionmentioning

confidence: 99%

The relationship between perianal fistula activity and abdominal adipose tissue in Crohn’s disease: an observational study

et al. 2022

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“…MRI is a highly accurate noninvasive modality for detecting and characterizing the presence and location of the primary fistulous track, secondary extension and accompanying abscess, as well as delineating its extent [ 16 , 17 ]. Due to its high spatial resolution and soft tissue contrast in the perianal region, MRI has become the preferred imaging modality for assessing perianal fistula [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional pelvic ultrasound is a practical tool for the assessment of anal fistula

Ren

Bai

et al. 2023

BMC Gastroenterol

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Objective This study aims to investigate the diagnostic value of three-dimensional pelvic ultrasound in the preoperative assessment of anal fistula compared with findings of MRI and surgery. Methods A total of 67 patients (62 males) with suspected anal fistula were analyzed retrospectively. Preoperative three-dimensional pelvic ultrasound and magnetic resonance imaging were performed in all patients. The number of internal openings and the type of fistula were recorded. The accuracy of three-dimensional pelvic ultrasound was determined by comparing these parameters with surgical outcomes. Results At surgery, 5 (6%) were extrasphincteric, 10 (12%) were suprasphincteric, 11 (14%) were intersphincteric, and 55 (68%) were transsphincteric. There was no significant difference in the accuracy of pelvic 3D US and MRI, based on internal openings (97.92%, 94.79%), anal fistulas (97.01%, 94.03%), and those under Parks classification (97.53%, 93.83%). Conclusion Three-dimensional pelvic ultrasound is a reproducible and accurate method for determining the type of fistula and detecting internal openings and anal fistulas.

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“…3,6 Incidentally, this classification does not find mention in the otherwise comprehensive literature review in the published article, 1 despite being validated recently in 848 patients 6 and in wide use. 2,7–9…”

Section: To the Editor—mentioning

confidence: 99%

Comparison Between the Modified Parks and Garg Classifications of Cryptoglandular Anal Fistulas

Dawka

Yagnik

2021

Diseases of the Colon &Amp; Rectum

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Magnetic resonance imaging findings in patients with initial manifestations of perianal fistulas

Cited by 8 publications

References 30 publications

The relationship between perianal fistula activity and abdominal adipose tissue in Crohn’s disease: an observational study

The relationship between perianal fistula activity and abdominal adipose tissue in Crohn’s disease: an observational study

Three-dimensional pelvic ultrasound is a practical tool for the assessment of anal fistula

Comparison Between the Modified Parks and Garg Classifications of Cryptoglandular Anal Fistulas

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