Ashiq Mohammed; Ajay Lucas; Afwaan Faizal; Paarthipan Natarajan
Abstract
A perianal fistula, characterized by an abnormal connection between the anal canal and perineal skin, is a relatively rare yet impactful condition. Surgical management is common, but ...
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A perianal fistula, characterized by an abnormal connection between the anal canal and perineal skin, is a relatively rare yet impactful condition. Surgical management is common, but recurrence remains a challenge. Accurate preoperative assessment is crucial, and magnetic resonance imaging (MRI) plays a pivotal role in identifying tracts, abscesses, and guiding surgical decisions.The study, involved 40 patients undergoing MRI fistulography before surgical intervention. Ethical approval was obtained, and data analysis included sensitivity, specificity, positive predictive values, and negative predictive values. Imaging protocols and sequences were meticulously applied using a Philips 1.5 TESLA MRI machine.Predominantly affects males (82.5%) in the 31-45 age group, perianal fistulas were classified using MRI. The majority were Type 1 tracts (46.15%). MR demonstrated high sensitivity (89.6%) and specificity (100%) in distinguishing fistulas from sinuses and identifying abscesses (100% sensitivity and 92.3% specificity). Side branches and extensions were identified with 76% sensitivity and 100% specificity.The study of 40 cases underscored MRI's efficacy in diagnosing perianal fistulas, demonstrating 89.6% sensitivity and 100% specificity. MRI emerged as the gold standard for visualizing perianal fistulas and identifying occult sepsis, surpassing alternative imaging methods.This study concludes that MRI is a reliable preoperative tool for perianal fistulas, offering high diagnostic accuracy and aiding surgical decision-making. While proctoscopic surgery remains definitive, MRI's superiority in visualizing complex fistula tract architecture justifies its gold-standard status in perianal fistula imaging. The study highlights the MRI potential in preventing postoperative complications like anal incontinence.
