Role of MRI in Perianal Fistula

Perianal Fistula

The aim of this study is to assess the diagnostic accuracy of MRI in detecting and assessment the primary fistulous tract, internal openings, secondary extensions, and associated abscesses. (and compare these findings with the surgical findings in patients who underwent surgery).

This study aims to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) in the preoperative assessment of anal fistula. MRI has become an essential imaging modality for the evaluation of perianal fistulous disease due to its superior soft-tissue contrast and ability to delineate fistulous tracts, internal openings, secondary extensions, and associated abscesses. Patients clinically suspected of having anal fistula and scheduled for surgical management will undergo preoperative MRI examination. The MRI protocol will include multiplanar T1-weighted and T2-weighted sequences, with or without fat suppression, to accurately identify the primary fistulous tract, internal opening, secondary ramifications, and any associated collections. MRI findings will be recorded and classified according to standard fistula classification systems. These findings will then be compared with intraoperative surgical findings, which will be considered the reference standard. The primary objective of this study is to determine the diagnostic accuracy of MRI in identifying the primary tract, internal opening, secondary extensions, and associated abscesses. Secondary objectives include assessing the role of MRI in preoperative planning and evaluating its ability to reduce recurrence rates through better delineation of fistulous anatomy. The results of this study may contribute to improving preoperative evaluation strategies and optimizing surgical management in patients with perianal fistula.

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