Comparison between the Accuracy of Endoanal Ultrasonography and Body Coil MRI in Preoperative Assessment of Internal Opening of Perianal Fistula Complex
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- Category: Vol. 83, March 2015
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Comparison between the Accuracy of Endoanal Ultrasonography and Body Coil MRI in Preoperative Assessment of Internal Opening of Perianal Fistula Complex, AHMED F. AHMED, HAITHAM S.E. OMAR, ABDRABOU N. MASHHOUR, HANY M.S. MIKHAIL, MOHAMED M.A. RASLAN, AHMED M.S.M. MARZOUK and HEBA O. EL-SAYED
Abstract
Background and Aim: Surgery for anal fistula is a com-monly performed practice. Integral part of fistula surgery is identification of the internal opening if high recurrence rate is to be diminished. In this study, accuracy of endoanal ultrasound versus body coil M.R.I in detection of the internal fistula opening was evaluated by comparing both modalities with the intra operative findings as a standard reference.
Material and Methods: In this prospective comparative study 60 patients were enrolled in during the period from (December 2012 to June 2014). Both Endoanal Ultrasonogra-phy (2D/3D) with or without H2O2 enhancement and Body coil phased array M.R.I were done for all patients. Internal opening site was localized by each modality with the surgeons performing the operations blinded to preoperative findings. Both results of the two modalities were compared against intraoperative findings as a standard reference to assess accuracy of each modality as well as the agreement between them.
Results: Regarding the diagnosis of the internal opening of the perianal fistula by both modalities, our study showed that the Endoanal Ultrasound had accurately diagnosed 53 cases out of 60 (88.3%) while 7 cases were inaccurately diagnosed (11.7%). On the other hand; The M.R.I had accu-rately diagnosed 29 cases out of 60 (48.3%) with inaccurate 31 cases (51.7%).
Conclusion: Endoanal ultrasonography with the recent innovations of 3D technique and the enhanced view with H2O2, is more accurate than Body coil M.R.I in localization of the internal opening of the perianal fistula complex thus; it can be considered the first choice when planning for fistula surgery especially that it has more advantages over M.R.I as its quickness (takes <10minutes), and portability (can be performed in the operating room). Also no radiation hazards are encountered with EAUS, like those in C.T or conventional fistulography.