3T MR imaging evaluation of perianal fistulas: an initial experience in Nepal

Introduction: Fistula–in–ano is an abnormal perianal tract that connects anal canal to the perianal skin. Improper visualization of primary fistulous tract and the associated abscesses or secondary tracts a r e the causes of recurrence. Earlier imaging modalities like conventional fistulography, en...

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Autor principal:	Ghanshyam Gurung
Formato:	article
Lenguaje:	EN
Publicado:	Society of Surgeons of Nepal 2016
Materias:	Abscess fistula MRI Secondary tract Surgery RD1-811
Acceso en línea:	https://doaj.org/article/690853929f1a4963bed2fbebc8ffa424
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spelling	oai:doaj.org-article:690853929f1a4963bed2fbebc8ffa4242021-12-05T19:16:50Z3T MR imaging evaluation of perianal fistulas: an initial experience in Nepal10.3126/jssn.v19i1.245521815-39842392-4772https://doaj.org/article/690853929f1a4963bed2fbebc8ffa4242016-06-01T00:00:00Zhttps://www.nepjol.info/index.php/JSSN/article/view/24552https://doaj.org/toc/1815-3984https://doaj.org/toc/2392-4772 Introduction: Fistula–in–ano is an abnormal perianal tract that connects anal canal to the perianal skin. Improper visualization of primary fistulous tract and the associated abscesses or secondary tracts a r e the causes of recurrence. Earlier imaging modalities like conventional fistulography, endosonography and CT scan have had limited role. Even without endorectal coils, 3T MRI has multi-planar imaging capability and excellent soft tissue differentiation to show perianal anatomy, primary and secondary tracts with associated abscesses in relation to sphincter complex. It provides excellent road map to surgeons for preoperative evaluation. The objective of the study was to evaluate the role of 3T MR in imaging of perianal fistulas. Methods: A retrospective study was done among 32 patients who were referred for MR fistulogram for suspected perianal fistula at Jeebanta Advanced Kathmandu Imaging, Durbar Marg, Kathmandu, Nepal. All images and findings were obtained and recorded with the help of Philips Ingenia 3T digital broadband MR scanner. Imaging was performed in oblique coronal and oblique axial plane. MR images were studied and grading system was applied according to the St James’s University Hospital Classification. The data were entered in a performa and was analyzed using IBM SPSS V21. Results: Male to female ratio was 7:1. According to St. James University Hospital MR Imaging classification of perianal fistulas, most of the patients (25%) had Grade 4 followed by (12.5% each) Grade 0, Grade 1 and Grade 2 and (6.3% each) Grade 3 and Grade 5 fistulas. Mean age was 37.28 years (Std. deviation 11.9). Common internal opening in axial image was found at 5 0’ clock positions (31.3%). Mean length of the fistulous tract was 3.9 cm (Std. deviation 2.3). Conclusion: Perianal fistulas are more common in males and Grade 4 fistulas are the commonest. MRI is well-tolerated, painless and non-invasive technique and has multiplanar capabilities with excellent tissue differentiation of pelvic muscle along with sphincter complex. Ghanshyam GurungSociety of Surgeons of NepalarticleAbscessfistulaMRISecondary tractSurgeryRD1-811ENJournal of Society of Surgeons of Nepal, Vol 19, Iss 1 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Abscess fistula MRI Secondary tract Surgery RD1-811
spellingShingle	Abscess fistula MRI Secondary tract Surgery RD1-811 Ghanshyam Gurung 3T MR imaging evaluation of perianal fistulas: an initial experience in Nepal
description	Introduction: Fistula–in–ano is an abnormal perianal tract that connects anal canal to the perianal skin. Improper visualization of primary fistulous tract and the associated abscesses or secondary tracts a r e the causes of recurrence. Earlier imaging modalities like conventional fistulography, endosonography and CT scan have had limited role. Even without endorectal coils, 3T MRI has multi-planar imaging capability and excellent soft tissue differentiation to show perianal anatomy, primary and secondary tracts with associated abscesses in relation to sphincter complex. It provides excellent road map to surgeons for preoperative evaluation. The objective of the study was to evaluate the role of 3T MR in imaging of perianal fistulas. Methods: A retrospective study was done among 32 patients who were referred for MR fistulogram for suspected perianal fistula at Jeebanta Advanced Kathmandu Imaging, Durbar Marg, Kathmandu, Nepal. All images and findings were obtained and recorded with the help of Philips Ingenia 3T digital broadband MR scanner. Imaging was performed in oblique coronal and oblique axial plane. MR images were studied and grading system was applied according to the St James’s University Hospital Classification. The data were entered in a performa and was analyzed using IBM SPSS V21. Results: Male to female ratio was 7:1. According to St. James University Hospital MR Imaging classification of perianal fistulas, most of the patients (25%) had Grade 4 followed by (12.5% each) Grade 0, Grade 1 and Grade 2 and (6.3% each) Grade 3 and Grade 5 fistulas. Mean age was 37.28 years (Std. deviation 11.9). Common internal opening in axial image was found at 5 0’ clock positions (31.3%). Mean length of the fistulous tract was 3.9 cm (Std. deviation 2.3). Conclusion: Perianal fistulas are more common in males and Grade 4 fistulas are the commonest. MRI is well-tolerated, painless and non-invasive technique and has multiplanar capabilities with excellent tissue differentiation of pelvic muscle along with sphincter complex.
format	article
author	Ghanshyam Gurung
author_facet	Ghanshyam Gurung
author_sort	Ghanshyam Gurung
title	3T MR imaging evaluation of perianal fistulas: an initial experience in Nepal
title_short	3T MR imaging evaluation of perianal fistulas: an initial experience in Nepal
title_full	3T MR imaging evaluation of perianal fistulas: an initial experience in Nepal
title_fullStr	3T MR imaging evaluation of perianal fistulas: an initial experience in Nepal
title_full_unstemmed	3T MR imaging evaluation of perianal fistulas: an initial experience in Nepal
title_sort	3t mr imaging evaluation of perianal fistulas: an initial experience in nepal
publisher	Society of Surgeons of Nepal
publishDate	2016
url	https://doaj.org/article/690853929f1a4963bed2fbebc8ffa424
work_keys_str_mv	AT ghanshyamgurung 3tmrimagingevaluationofperianalfistulasaninitialexperienceinnepal
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3T MR imaging evaluation of perianal fistulas: an initial experience in Nepal

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