Three‐dimensional endoanal ultrasound is accurate and reproducible in determining type and height of anal fistulas

Abstract

3D-EAUS is an accurate and reproducible modality for the assessment of type and height of anal fistulas.

The treatment of anal fistula: secondACPGBIPosition Statement – 2018

“…When this technique is used by enthusiasts to assess anal sepsis similar accuracy can be achieved to assessment by endocoil MRI, with an accuracy of over 80% and near 100% concordance with surgery for simple cases and 68% for high fistulas . The height and type of fistula seen on ultrasound compares well with the findings at examination under anaesthesia (EUA; 91% accuracy for type and 92% accuracy for classification of ‘high’ or ‘low’) .…”

Role of MRI Fistulography with Gadopentate Enhancement in Assessment of Complex Anal Fistulas and Improving Surgical Outcomes

“…Other surgeons endorsed the use of ERUS for evaluation of FIA before surgery proposing that the results of hydrogen peroxide-enhanced ERUS are comparable to MRI [20]. The advent of three dimensional technology made ERUS a more accurate and reproducible tool in determining the type and height of anal fistulae as reported in a recent study [12]. Although ERUS can effectively assess some types of complex FIA, MRI is generally deemed superior for the appraisal of more complex anal fistulas [21].…”

“…Kołodziejczak et al [12] described 3D-ERUS as an accurate and reproducible modality for the assessment of type and height of anal fistulae with overall accuracy 91% for fistula type and 92% for fistula height. On the other hand, both modalities were reported to have comparable sensitivity, yet with higher specificity in favor to MRI [13].…”

A novel template for anorectal fistula reporting in anal endosonography and MRI – a practical concept

“…MRI can be performed with an external or endorectal coil. Both techniques provide the visualization of the fistula anatomy and the evaluation of the morphology of the anal sphincters as well as the perianal and perirectal spaces (ischiorectal fossae and supralevator space), with MRI having the advantage due to a wider field of view, multiplanarity and ability to differentiate active tract with scar tissue on postcontrast images [6,7].…”