Magnetic resonance imaging for fistulography in perianal fistula: clinicoradiological correlation

Abstract

Background: This article aims to review the role of magnetic resonance imaging (MRI) fistulography in evaluation of perianal fistula along with its concordance with clinical examination and impact on surgical intervention.Methods: A retrospective study of 61 patients who underwent surgery for anal fistula in RMLIMS collected from database from January 1, 2017 to September, 2021Results: The study showed a significant MRI contribution to clinical evaluation in 65.6%. MRI provided significant information for complex fistu­las than for simple fistulas (45% vs. 14.6%, p=0.01). Proportion of patients with sig­nificant MRI contribution increased with in­creasing Parks grade (grade 1, 8.3%; grade 2, 52.2%, p=0.001). The concordance between St. James Hos­pital grade and Parks classification was 0.768 (Kappa coefficient, p<0.00).Conclusions: Therefore, we propose inclusion of MRI in the preoperative surgical assessment of anal fistulas when recurrent, complex, high grade, or when the external opening is located more than 2 cm from the anal canal.