MRI-based Evaluation of Perianal Fistulas: A Pictorial Review

Dr. Sharath Gopal Surendran, Dr. Prashanth G Patil, Dr. Chethan T N

Abstract: Background: Perianal fistulas are abnormal tracts that originate from the anal canal and extend to the perianal skin or surrounding tissues. They are a common cause of recurrent perianal sepsis and can significantly impact a patient?s quality of life due to pain, discharge, and in some cases, fecal incontinence. Recurrence is common, especially when secondary extensions or abscesses are not detected prior to surgery. MRI has emerged as the gold standard imaging modality for evaluating perianal fistulas. It offers high-resolution multiplanar imaging and superior soft-tissue contrast, enabling precise delineation of the fistulous tract, its relationship with the anal sphincters, and any associated abscesses or secondary tracts. Aims: To characterize the various types of perianal fistulas in patients referred to our institution. Conclusion: MRI plays a pivotal role in evaluating perianal fistulas, enabling precise classification, detection of secondary tracts or abscesses, and facilitating tailored surgical planning. Adoption of the St. James classification improves diagnostic accuracy and surgical outcomes. Radiologists must be familiar with this classification and relevant pelvic anatomy to provide optimal care.

Keywords: perianal fistula, mri fistulogram, st. james classification, sphincter complex, fistulous tract, surgical planning

How to Cite?: Dr. Sharath Gopal Surendran, Dr. Prashanth G Patil, Dr. Chethan T N, "MRI-based Evaluation of Perianal Fistulas: A Pictorial Review", Volume 14 Issue 7, July 2025, International Journal of Science and Research (IJSR), Pages: 588-590, https://www.ijsr.net/getabstract.php?paperid=SR25709000844, DOI: https://dx.doi.org/10.21275/SR25709000844