Contribution of preoperative magnetic resonance imaging in diagnosis and surgical treatment of anal fistula

• DOI: 10.17826/cumj.780148
• Publication Date: 2020-09-27T11:02:13Z
• Authors: Mehmet BAYRAK; Yasemin ALTINTAŞ; Ömer ALABAZ; Medih ÇELİKTAŞ
• Keywords: Klinik Tıp Bilimleri; 03 medical and health sciences; 0302 clinical medicine; Clinical Sciences; Anal fistül;manyetik rezonans görüntüleme;cerrahi tedavi; anal fistula;magnetic resonance imaging;surgical treatment; 3. Good health

Purpose: This study aims to investigate the accuracy of MR imaging in patients with anal fistula and the information quantitatively added by MR imaging and to identify the group of patients where MR imaging is more likely to provide complementary information. Materials and Methods: The present cohort was a retrospective work of consecutive patients diagnosed with primary anal fistula who underwent surgery and preoperative MR imaging between 15 January 2018 and 15 June 2020. Any complementary radiological information was derived from preoperative MR imaging reports. The inconsistencies were noted between surgical findings and MR imaging records. Results: The study consisted of 160 patients with 179 tracts, 92 men and 68 women. The mean patient age was 44.6±10.1 (18-65) years. In total, 97 patients suffered from recurrent fistulas (60.6%). The specificity and sensitivity of MR imaging in detecting fistula tracts were 93.5 and 98.9 % %, respectively. The diagnostic accuracy of MR imaging in identifying the fıstula tract and internal opening was 97.8 % and 97.5%, respectively. The contribution of preoperative MR imaging was statistically more significant if the external opening was over 3 cm from the anal canal (10.9% vs. 47.8%,) and when a horseshoe fistula was present (39.6% vs. 63.8%). Conclusion: We found that MR imaging had high specificity, sensitivity, and diagnostic accuracy in discovering both fistula tracts and the internal opening, we consider that MR imaging should be used routinely in almost all simple and complex fistulas.