Value For Diagnosis In The Complicated Fistulas And Clinical Application By MRI

Objective: The purpose of this study was to determinethe accuracy of synergic body coil MRI using STIR technique in contrast to physical examination, in the determin- ation of fistula characteristics in patients with clinically positive signs.Method and subjects : This was a case-series prospective study including twenty two consecutive patients with clinically suspected fistulas-in-ano. The standard synergic body coil was used and all patients had T2-weighted SPIR sequences. One radiologist, without prior knowledge of the clinical examination, analysed images and noted the presence of the fistula, its classification and the presence and number of any collections or extensions. The surgeon noted the MRI findings and looked for lesions. suggested on MRI. The results of the MRI and surgical assessments were then compared. Results of surgical exploration while the surgeon was aware of MRI results were considered as the gold standard of surgical anatomy.Results: Body coil MRI was superior to physical examination 16 (88.89%) of 18 fistula tracks were seen on MRI which correctly determined the type of all fistulas. In the two cases where the fistula was not seen on MRI, four were low transphincteric and three were rectal tumors.. MRI identified 13 of 18 setons.Conclusion: The synergic body coil MRI with SPIR sequencing without endoanal coils had a high accuracy in the diagnosis of high fistulas collections, complex fistulas and extensions.