The Use of Magnetic Resonance Imaging in Patients with Chronic Paraproctitis (Preliminary Results)

Aim.Investigation of possibilities of magnetic resonance imaging as a whole, as well as different modes of MR scanning (without intravenous contrast, with intravenous contrast, with the use of diffusion-weighted imaging) in the diagnosis of cryptogenic fistulas of the rectum.Materials and methods. In the study were included 50 patients with cryptogenic fistulas of the rectum (21 women and 29 men). All patients underwent magnetic resonance imaging of the pelvic organs.Results.The sensitivity of MRI in the diagnosis of the primary fistulas was 100%. With regard to secondary fistulas MRI sensitivity was 91.7%, specificity was 94.3%. The sensitivity of MRI in the diagnosis of chronic abscesses paraproctitis was 82.6%, specificity was 95.2%. The sensitivity of the method in the visualization of internal opening was 95.5%, specificity was 80.0%. The sensitivity of the method in the diagnosis of external openings was 91.7% and specificity was 100%. In the analysis of separates MR scanning mode we didn’t find statistically significant differences between them (p < 0.05). Conclusions.Magnetic resonance imaging has a high diagnostic efficacy in the diagnosis of cryptogenic perianal fistulas. We didn’t find statistically significant differences between MR scanning modes.

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Magnetic resonance imaging of perianal fistulas: predictive value for Parks classification and identification of the internal opening

Colorectal Disease ◽

10.1046/j.1463-1318.2000.00181.x ◽

2000 ◽

Vol 2 (6) ◽

pp. 340-345 ◽

Cited By ~ 6

Author(s):

B. Holzer ◽

H. R. Rosen ◽

M. Urban ◽

W. Anzbock ◽

R. Schiessel ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Predictive Value ◽

Internal Opening ◽

Resonance Imaging ◽

Perianal Fistulas

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Magnetic Resonance Imaging of Perianal Fistulas in Clinically Symptomatic Patients and the Correlation Among Plain, Contrast, and Post Jelly MRI Fistulography

Journal of Coloproctology ◽

10.1055/s-0041-1730260 ◽

2021 ◽

Author(s):

Ruchi Gupta ◽

Subhash Kumar ◽

Anil Kumar ◽

Richa Tiwari ◽

Neetu Sinha

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Kappa Statistic ◽

Type I ◽

Resonance Imaging ◽

Intravenous Contrast ◽

Diagnostic Modality ◽

Female Ratio ◽

Perianal Fistulas ◽

Significant Agreement

Abstract Objectives To evaluate different types of perianal fistulas and their complications on magnetic resonance imaging (MRI) and to compare plain, contrast, and jelly magnetic resonance fistulography findings. Materials and Methods This prospective study was performed in 30 patients who presented with perianal pus discharge or external fistulous opening. Magnetic resonance imaging of the perianal region before and after giving intravenous contrast and after injecting jelly through a percutaneous opening was performed on a 3T scanner and the results were correlated. Results The mean age of the patients was 40.13 ± 13.88 years (range 19–75 years). The male to female ratio was 14:1. The most common type of fistula was St. James classification type I, which was seen in 13 patients (43%), followed by type IV in 30%, type III in 16%, type II in 6.66%, and type V in 3.33% of the patients. Using agreement analysis, we compared the number of primary and secondary tracts, internal openings, and horseshoe tracts and found a significant agreement between plain and post Jelly MRI fistulography (kappa statistic close to 1). When comparing plain and contrast MRI, there was significant agreement in the primary and secondary tracts, while statistically insignificant results were obtained (p > 0.05) for the horseshoe tract and internal openings. Contrast injection was helpful in 7 subjects (23.3%) as peripheral enhancement of abscesses were better delineated. Conclusion Magnetic resonance imaging is the one stop diagnostic modality for perianal fistulas. Acquisition of axial (Ax) T2, axial T2 FS, coronal T2 and coronal T2 FS sequences without administering intravenous contrast or jelly is usually sufficient for the diagnosis of fistulas and their complications.

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