Perianal MRI: As a Diagnostic Tool in Preoperative Evaluation of Fistula-in-Ano

Dr. Yogesh Kumar ^[4] | Dr. Avdhesh Sharma | Dr. S. S. Rathore ^[2] | Dr. Mahendra Choudhary | Dr. Ugam Singh

Abstract: Background: Fistula-in-ano is an abnormal tract lined by epithelium or by the granulation tissue between anal canal and skin of the perineum. Nowadays the trend of using imaging techniques before planning the surgery is increasing, especially the use of MRI as it provides more precise information about the tract. Our prospective study correlated the MRI, clinical and intra-operative findings and calculated the sensitivity and specificity in detecting various features about the fistulous tract. Method: An institutional based prospective and observational study was performed in Department of General Surgery at MGH & MDM Hospital affiliated with Dr S. N. Medical College, Jodhpur, Rajasthan, India. Patients were selected and then subjected to perianal MRI before surgery and the data was collected and compared. Results: Sensitivity and specificity of perianal MRI in detecting internal opening and complicated fistulous tract was found to be (100%, 40%) and (100%, 84.62%) respectively. Conclusion: It was concluded from our study that MRI of the perianal region is the preferred modality for the diagnosis of fistula-in-ano and its complications preoperatively. It also aids in delineation of tract pathway and its relation to the anal sphincter complex and thus is helpful in preventing the injury to sphincter and resulting fecal incontinence.

Keywords: Fistula-in-ano, perianal MRI, St. James?s grading, Goodsall, complicated fistulous tract

Edition: Volume 12 Issue 5, May 2023,

Pages: 2541 - 2543