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Published on: April 17, 2019
Added value of volumetric MRI pulse sequence 3D VISTA (Volume ISotopic Turbo spin echo Acquisition) in perianal
Ahmed I Tawfik1, Amir M Eltantawy1, Mohamed Mohsen1
1Radiology Department, Mansoura University, Mansoura, Egypt.
Purpose:
Diagnosis of perianal fistula represents a challenge for surgeons. It is well known that magnetic resonance imaging (MRI) plays an important role in that. The new 3D MRI sequence VISTA (Volume ISotopic Turbo spin echo Acquisition) can improve detection and characterization of perianal fistula compared with two-dimensional (2D) sequences. The aim of the study was to compare the diagnostic performance of the new 3D MRI sequence VISTA with the widely routinely used T2 FSE pulse sequence in depiction and characterization of perianal fistula by using the contrast-enhanced (CE) 3D T1 sequence THRIVE (T1-weighted high-resolution isotropic volume examination) as a reference standard.
Material And Methods:
Forty adult patients were enrolled in this prospective study. They underwent MRI perianal region examination using routine T2 TSE and CE 3D T1 sequence THRIVE with addition of the new 3D MRI sequence VISTA. T2, 3D VISTA and (CE) 3D T1 sequence THRIVE images were evaluated by two radiologists separately for detection and characterization of perianal fistula, then comparison between of T2 and 3D VISTA sequences was done using (CE) 3D T1 sequence THRIVE as a reference. Each sequence sensitivity, specificity and accuracy were calculated by both readers.
Results:
For reader 1, the sensitivity, specificity and accuracy were 92.5%, 90.5% and 93.6% for 3D VISTA and 84.1%, 83.7% and 87.3% for T2 FSE. For reader 2, the sensitivity, specificity and accuracy were 91.5%, 92.8% and 94.8% for 3D VISTA and 82.9%, 84.5% and 86.7% for T2 FSE.
Conclusions:
Using CE 3D T1 sequence THRIVE as the reference standard, 3D VISTA pulse sequence on the perianal region has better diagnostic performance in the detection and characterization of perianal fistula as compared to the routinely used T2 FSE sequence.
Insights
The new 3D VISTA MRI sequence offers improved detection and characterization of perianal fistulas compared to the standard T2 FSE sequence. This advanced imaging technique enhances diagnostic accuracy for perianal fistula evaluation.
Area of Science:
- Radiology
- Medical Imaging
- Gastroenterology
Background:
- Perianal fistula diagnosis is challenging for surgeons.
- Magnetic resonance imaging (MRI) is crucial for perianal fistula evaluation.
- Traditional 2D MRI sequences have limitations in fistula detection.
Purpose of the Study:
- To compare the diagnostic performance of the 3D VISTA MRI sequence with the routine T2 FSE sequence.
- To evaluate the efficacy of 3D VISTA in detecting and characterizing perianal fistulas.
- To use contrast-enhanced 3D T1 THRIVE as a reference standard for comparison.
Main Methods:
- Prospective study of 40 adult patients with perianal fistulas.
- MRI perianal region examination using T2 FSE, 3D VISTA, and contrast-enhanced 3D T1 THRIVE sequences.
- Independent evaluation of image sequences by two radiologists for fistula detection and characterization.
Main Results:
- 3D VISTA demonstrated higher sensitivity, specificity, and accuracy than T2 FSE for both readers.
- Reader 1: 3D VISTA (92.5% sensitivity, 90.5% specificity, 93.6% accuracy) vs. T2 FSE (84.1% sensitivity, 83.7% specificity, 87.3% accuracy).
- Reader 2: 3D VISTA (91.5% sensitivity, 92.8% specificity, 94.8% accuracy) vs. T2 FSE (82.9% sensitivity, 84.5% specificity, 86.7% accuracy).
Conclusions:
- The 3D VISTA MRI sequence shows superior diagnostic performance for perianal fistulas compared to T2 FSE.
- 3D VISTA improves both detection and characterization of perianal fistulas.
- This advanced MRI technique offers a valuable tool for surgical planning and patient management.
