Value of Magnetic Resonance Imaging in the Surgical Management of Perianal Fistulas
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- Category: Vol. 80, December 2012
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Value of Magnetic Resonance Imaging in the Surgical Management of Perianal Fistulas,DOAA I. HASAN, AHMED A. ISMAIL and FATEN F. MOHAMED
Abstract
Background: To understand the surgical options for treating fistulous disease, one must first consider the anatomy, function of the anal sphincters and the causes of perianal fistulas.
Aim of the Work: Was to evaluate the use of (MR) imaging in diagnosis of perianal fistulous disease and its relationship to the anal sphincter, pelvic diaphragm (levator plate) and the ischiorectal fossae.
Material and Methods: This study was performed at MRI unit of Radiology Department and Surgery Department of the Zagazig University Hospitals at period from July 2008, to October 2010. During this study period 47 cases with clinical diagnosis of perianal fistula, were referred to MRI scan. Of the 47 patients, 37 were males (79%) and 10 females (21%).
Results: In this study the sensitivity of MR in detection of fistula type was 97.87%, specificity 88.46%. The sensitivity and specificity for detection of associated abscesses were 94.73% & 89.47% respectively. The sensitivity and specificity for detection of horse shoe extension were 100%. For detection of internal opening the sensitivity and specificity were 97.87% & 85.10% respectively.
Conclusion: MRI can accurately identify the fistula track in relation to the sphincter complex. This may provide more accurate anatomical information about the amount of sphincter above the track, the position and level of the internal opening there by increasing the likelihood of rapid successful surgical treatment.