Usefulness assessment of preoperative MRI fistulography in perianal fistulas patients.

Abstract

Introduction: Perianal fistulas with a complex, branched and high course, especially in patients after previous surgeries or patients with Crohn disease. Aim: Application of MRI fistulography for evaluation of cases of perianal fistulas difficult to diagnose and treat. Materials and methods: 31 patients with ano-rectal fistula were enrolled in this study. MRI fistulography findings were analyzed and compared with intraoperative conditions in 31 patients (19 men and 12 women). Imaging was performed with a 1.5-Tesla field strength and a dedicated surface coil placed at the level of hip joints. Contrast agent was a gadolinium-based solution. Results: 30 MRI fistulographic findings Intraoperatively were consistent with radiological descriptions. According to surgery findings, only one case was a transsphincteric fistula with an abscess in the ischioanal fossa, with an orifice in the posterior crypt, the radiologist described it as a transsphincteric, internal blind fistula. Conclusion: MRI fistulography becomes a useful and recommended diagnostic method. It point the location of the fistula regarding the system of anal sphincters, and identifies the internal orifice and branching of the fistula. It enables precise planning of surgical treatment