Value of contrast enhanced spoiled gradient (SPGR) MR and MIP MR imaging in diagnosis of peri-anal fistula

Mazroa, Jehan A.; El-Mogy, Sabry; El-Gendy, M. E.

doi:10.1016/j.ejrnm.2012.01.004

Cited by 6 publications

(3 citation statements)

References 26 publications

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“…Their results showed a diagnostic accuracy of 99.4% for post contrast fat suppressed T1 TSE. Our results were also comparable to the results of Mazroa et al (32) and Daabis et al (33) , they found the diagnostic accuracy of post contrast sequence in the detection of perianal fistula to be 97.3% and 95% respectively.…”

Section: Discussionsupporting

confidence: 92%

The Value of Magnetic Resonance Imaging in the Evaluation of Peri-Anal Fistula

Jawad¹,

Kadhim²,

Al-Jobouri³

et al. 2018

IraqiJMS

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Background: Perianal fistula accounts for 0.01% of general population and is frequently managed inadequately resulting in a significant morbidity. Magnetic resonance imaging (MRI) plays an essential role in the preoperative assessment of the disease, therefore improving post-operative surgical outcome. Objective: To study the role of MRI in the evaluation of perianal fistula and to show the value of using contrast enhanced MR study in the determination of the precise tract pathway, extensions and other associated pathologies. Methods: A cross sectional analytic study was conducted on a total of 32 patients with perianal fistulas in the MRI Department of Al-Imamein Al-Kadhimein Medical City, Baghdad, Iraq during the period from November 2015 to December 2016. Patients underwent MRI examination using axial and coronal T2 weighted images with and without fat suppression and T1 fat suppressed sequences before and after contrast administration. The type of fistula, location of the internal opening, associated abscesses and/or sinus tracts and horseshoe extension were evaluated using different MR sequences. Results: The most common type of fistula encountered was the inter-sphincteric type, which was seen in 21 patients (66%), of those patients 16 fistulas (50%) were grade I and 5 fistulas (16%) were grade II. Trans-sphincteric fistulas were seen in 9 patients (28%), 2 of them (6%) were grade III and 7 fistulas (22%) were grade IV. Two patients (6%) had extra-sphincteric type. T2 weighted TSE, T2 TSE with fat suppression and T1 weighted fat suppressed post contrast sequences all show significant correlation with surgical results (with p-value less than 0.05) and the highest significance was obtained by the post contrast sequence (p-value of 0.00001). The highest accuracy in the diagnosis of fistula in ano was with the use of T1 enhanced fat suppressed sequence (98.8%) followed by 87% for the T2 fat suppression sequence and only 57% for the T2 weighted TSE sequence. Conclusion: MRI is an essential, noninvasive tool in the preoperative assessment of perianal fistulous tracks, with the axial and coronal post contrast fat suppression T1 providing the highest accuracy and clinical significance with surgical data and therefore giving a highly promising decrement in the incidence of post-operative complications. Keywords: MRI, perianal fistula Citation: Jawad AM, kadhim MA, Al-Jobouri ZK, Hussain MAA. The value of magnetic resonance imaging in the evaluation of peri-anal fistula. Iraqi JMS. 2018; 16(2): 166-176. doi: 10.22578/IJMS.16.2.8

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Section: Discussionsupporting

confidence: 92%

The Value of Magnetic Resonance Imaging in the Evaluation of Peri-Anal Fistula

Jawad¹,

Kadhim²,

Al-Jobouri³

et al. 2018

IraqiJMS

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“…Magnetic Resonance Imaging (MRI) is predominantly preferred for diagnosing the anal region fistula, anovaginal, and rectovaginal fistula's anatomy [3]. CT usually fails to visualize inflammatory disease and also perianal abscess as it lacks soft-tissue resolution [7,8] and also fails in correct perianal fistula's classification as it fails to show the tract near the sphincter ani externus muscle and levator muscle, which results from the similar attenuation values [21,22]. On MRI and EUS, the abscess that contains air may be difficult to interpret from bowel air, but CT is free from this limitation [14].…”

Section: St James University Hospital's Classificationmentioning

confidence: 99%

“…3 tesla (T) MRI scanner), which gives better signal-to-noise ratio (SNR), increased spatial resolution that improves the lesion's visibility, increased temporal resolution, and reduced scan time [7]. Another crucial drawback of pulse sequence provides higher resolution images with fair visibility of lateral ramifications and fistula extensions [21]. To rule out the position of the set on after surgery, T1 weighted gradient echo imaging sequence was used [20].…”

Section: Pulse Sequencesmentioning

confidence: 99%

The Role of Diagnostic Medical Imaging Techniques in the Evaluation of Perianal Fistula: A Review

Adityan¹,

Paul²

2021

Int J Radiol Imaging Technol

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The fistula in ano or perianal fistula is one of the common fistulae noted in routine surgical and clinical practice. It has the tendency to reoccur even after surgery, which is due to missed pathological tract or tissue during surgical exploration. An adequate pre-surgical mapping is a necessity for giving an excellent surgical outcome and choosing an appropriate surgical technique for treating various fistulas. So, medical imaging modalities like X-ray fistulography, endoanal ultrasonography, computed tomography fistulography, and the magnetic resonance fistulography were used for assessing fistula. Among these, magnetic resonance fistulography is the commonly preferred diagnostic medical imaging technique for interpreting the fistula as it has higher resolution on soft tissues, non-usage of ionizing radiation, which reduced the threat of radiation-induced cancer, and non-invasive imaging technique, which reduces patient discomfort and complications. The perianal region fistula is mainly classified into two types namely, park's classification and St. James university hospital's classification. Hence in this literature, we have reviewed the importance of medical imaging modality in interpreting perianal fistula, especially magnetic resonance fistulography, as an accurate preoperative, post-operative, and follow-up medical imaging modality for the perianal fistula's imaging. The subtraction technique, dynamic contrast imaging, volume imaging, and percutaneous instillation of aqueous jelly into the perianal fistula tract are the latest advances in imaging perianal fistula.

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