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[Magnetic resonance imaging of patients with perianal fistulas]
K T Nielsen1, E Lundorf, T Christensen
1Arhus Amtssygehus, kirurgisk afdeling L.
Abstract:
Magnetic resonance imaging (MRI) of the anal canal was retrospectively evaluated during a three year period in 67 patients with suspected perianal fistulae. In six cases the surgeon, who knew the results of the MRI, found a fistula not seen on MRI while MRI showed a fistula in one patient which could not be found at surgery. We recommend MRI in cases where an experienced surgeon has difficulties mapping the fistula tract.
Insights
Magnetic resonance imaging (MRI) is a valuable tool for mapping complex anal fistulae when surgeons encounter difficulties. While generally accurate, MRI may miss some fistulae or identify non-existent ones, necessitating surgical correlation.
Area of Science:
- Radiology
- Gastroenterology
- Surgical Anatomy
Context:
- Perianal fistulae present diagnostic challenges.
- Accurate fistula tract mapping is crucial for successful surgical outcomes.
- Magnetic resonance imaging (MRI) is increasingly used for anal canal evaluation.
Purpose:
- To evaluate the diagnostic accuracy of MRI in identifying anal fistulae.
- To determine the utility of MRI in complex cases where surgical mapping is difficult.
Summary:
- A retrospective review of 67 patients with suspected perianal fistulae evaluated MRI accuracy.
- MRI identified fistulae in most cases but had discrepancies with surgical findings in 7 instances (6 missed by MRI, 1 false positive).
- MRI is recommended for challenging fistula tract mapping when surgical assessment is difficult.
Impact:
- MRI can aid surgeons in complex perianal fistula cases.
- Highlights the need for surgical correlation with imaging findings.
- Informs clinical decision-making for fistula management.