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Scholars Journal of Applied Medical Sciences | Volume-6 | Issue-03
Spectrum of MRI Imaging Findings of Peri-Anal Fistulas in 20 Cases
Dr. Anshu Agarwal, Dr. Manu Gupta, Dr. Manish Bhagat
Published: March 30, 2018 | 145 143
DOI: 10.36347/sjams.2018.v06i03.091
Pages: 1268-1273
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Abstract
An abnormal connection between two structures or organs or between an organ and the surface of the body is defined as a fistula. In perianal fistula, there is a connection between the anal canal and the skin of the perineum. Perianal fistulation is an infrequent process, with a prevalence of 0.01%, although it is associated with signifi¬cant morbidity. It is now increasingly recognized that imaging techniques, especially magnetic resonance (MR) imaging, may play a crucial role. MR imaging allows identification of infected tracks and ab¬scesses that would otherwise remain undetected by other modalites. Furthermore MRI also provide detailed anatomic descriptions of the relationship be¬tween the fistula and the anal sphincter complex, thus allowing surgeons to choose the best surgical treatment, drastically reducing recur¬rence of the disease or possible secondary effects of surgery, such as fecal incontinence (4,5). We also highlight key details that radiologists should provide to surgeons to ensure effective treatment and improve thera¬peutic outcome. The study population comprised 20 patients referred from surgery department whose MRI studies were evaluated retrospectively in the Dept of Radiodiagnosis, Sri Aurobindo Institute of Medical Sciences & PG College from October 2016 and January 2018. All MRI studies were carried out on a 1.5-T MRI system (Seimens 1.5T) using an 8-channel phased-array coil. The sequences evaluated were: Axial T1 TSE; Axial fat-suppressed T2W; Axial post-contrast T1W [post injection of 10 ml of gadodiamide (Gd-DTPA-BMA); Coronal T1W TSE; Coronal T2W fat-suppressed and coronal post-contrast T1W. To summaries, a male preponderance is seen mostly in young adults with low lying type of fistulas being the most common, evaluation of an enhanced T1W image, in conjunction with a fat-suppressed T2W image, provides most of the details necessary for accurate evaluation of perianal fistulae.