Role Of Magnetic Resonance Imaging (MRI) Fistulogram In Assessment Of Perianal Fistulas

Abstract

Introduction: Perianal fistula is a rare condition, however causes substantial morbidity due to its chronicity. Recently, preoperative magnetic resonance imaging (MRI) has become an essential tool for doing a thorough investigation of the fistulous tract, grading of the fistula, concomitant abscess and secondary tracts, and to reduce chances of recurrence after surgery. Methods: A prospective observational hospital based study was done for a duration of 18 months. Patients with suspected perianal fistula were evaluated using MRI and the fistulous tracts were evaluated using the St.James University Hospital Classification. Results: The study confirmed a higher incidence of perianal fistulas among males and predominantly in the 41–50 age demographic. Most fistulas exhibited straightforward anatomical features, with single external and internal openings, and were concentrated at the 5-7 o'clock position, which could influence surgical approaches and outcomes. Based on the St. James University Hospital Classification, the most prevalent fistula was found to be Grade I. MRI was also useful in evaluating associated complications, if present.