Preoperative MRI of perianal fistula: Is it really indispensable? Can it be deceptive?

被引:8
作者
Agha, Mahmoud E. [1 ]
Eid, Mohamed [2 ]
Mansy, Hanan [3 ,4 ]
Matarawy, Khaled [1 ]
Wally, Mohsen [4 ]
机构
[1] Alexandria Univ, Med Res Inst, Alexandria, Egypt
[2] Alexandria Univ, Fac Med, Alexandria, Egypt
[3] Suez Canal Univ, Fac Med, Ismailia, Egypt
[4] Almana Gen Hosp, Al Hufuf, Saudi Arabia
关键词
Perianal fistula; Preoperative MRI; Recurrence; Incontinence; Fallacious; Color Doppler US;
D O I
10.1016/j.ajme.2012.09.003
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: The study aims not only to determine the value of preoperative MRI of perianal fistula but also to detect MRI fallacious results, if any. Also, it aims to suggest how we can limit such false positive MRI results that may lead to unnecessary surgery. Patients and methods: This was a prospective comparative study, included 100 patients. Fifty of them (group A) were operated following the guidance of preoperative MRI, while the other 50 patients (group B) directly operated without MRI. The study protocol was approved by the ethics committee in Al-Mana General Hospital. Results: Group A: surgically proven 24 patients grade 1, 13 grade 2, 4 grade 3, 4 grade 4 and 3 grade 5. MRI grading was 26 grades I, 13 grade 2, 4 grade 3, 4 grade 4 and 3 grade 5. Two patients were false positive. Postoperative complications: 2 recurrences, 1 incontinence and 1 both recurrence and incontinence. Group B: surgically proven 22 patients grade 1, 11 Grade 2, 8 grade 3, 3 grade 4 and 3 grade 5. Clinical preoperative grading was 42 patients grade 1 and 8 grade 2. Three patients were false positive. Postoperative complications: 17 recurrence, 6 incontinence, 3 concomitant recurrence and incontinence. Conclusion: MRI is a very helpful tool of preoperative imaging of perianal fistula. Its fallacious preoperative positive results that may lead to unnecessary surgeries can be corrected by standardizing IV gadolinium contrast as routine protocols or using complementary Color Doppler US examination of the fistulous track. (C) 2012 Alexandria University Faculty of Medicine. Production and hosting by Elsevier B.V. All rights reserved
引用
收藏
页码:133 / 144
页数:12
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