Preoperative assessment of complex fistula-in-ano (FIA) is crucial for decision making. Magnetic resonance imaging (MRI) has been used for assessment of perianal sepsis with various protocols and methods. The aim of the present study was to assess the concordance between MRI fistulography with gadopentate enhancement and the intraoperative surgical findings, and to study the impact of preoperative assessment with MRI on surgical outcomes including fistula recurrence and fecal incontinence (FI). Patients with complex and high FIA who were investigated by MRI fistulography preoperatively were reviewed. The concordance between the findings of MRI and the intraoperative findings on examination under anesthesia (EUA) was made using Kappa coefficient test. The accuracy and sensitivity of MRI were calculated regrading detection of the internal opening, primary and secondary fistula tracts. 95 patients (82% males) were included in the study. MRI fistulography had an accuracy of 89.4%, 96.8%, 96.8%, 98%, and 98% in detection of the internal opening, number of tracts, position of primary tract, secondary extensions, and presence of abscess cavities, respectively. Overall, there was very good concordance between MRI and EUA regarding the examined parameters (k= 0.847, 0.937, 0.908, 0.953, 0.957), respectively. Fistula recurrence and minor FI were recorded in 4.2% and 14.7% of patients. MRI fistulography is an effective diagnostic modality for the preoperative assessment of FIA. MRI had excellent accuracy and sensitivity in detection of the internal opening, primary tract, and secondary extensions of anal fistula with very good concordance with the intraoperative findings.
| Published in | Journal of Surgery (Volume 5, Issue 2) |
| DOI | 10.11648/j.js.20170502.13 |
| Page(s) | 22-27 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2017. Published by Science Publishing Group |
MRI, Fistulography, Anal Fistula, Complex, Assessment, Outcomes
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APA Style
Mahmoud Abdelnaby, Sameh Hany Emile, Ahmad Sakr, Alaa Magdy, ElYamani Fouda, et al. (2017). Role of MRI Fistulography with Gadopentate Enhancement in Assessment of Complex Anal Fistulas and Improving Surgical Outcomes. Journal of Surgery, 5(2), 22-27. https://doi.org/10.11648/j.js.20170502.13
ACS Style
Mahmoud Abdelnaby; Sameh Hany Emile; Ahmad Sakr; Alaa Magdy; ElYamani Fouda, et al. Role of MRI Fistulography with Gadopentate Enhancement in Assessment of Complex Anal Fistulas and Improving Surgical Outcomes. J. Surg. 2017, 5(2), 22-27. doi: 10.11648/j.js.20170502.13
AMA Style
Mahmoud Abdelnaby, Sameh Hany Emile, Ahmad Sakr, Alaa Magdy, ElYamani Fouda, et al. Role of MRI Fistulography with Gadopentate Enhancement in Assessment of Complex Anal Fistulas and Improving Surgical Outcomes. J Surg. 2017;5(2):22-27. doi: 10.11648/j.js.20170502.13
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Download@article{10.11648/j.js.20170502.13,
author = {Mahmoud Abdelnaby and Sameh Hany Emile and Ahmad Sakr and Alaa Magdy and ElYamani Fouda and Ahmed Abdel Mawla},
title = {Role of MRI Fistulography with Gadopentate Enhancement in Assessment of Complex Anal Fistulas and Improving Surgical Outcomes},
journal = {Journal of Surgery},
volume = {5},
number = {2},
pages = {22-27},
doi = {10.11648/j.js.20170502.13},
url = {https://doi.org/10.11648/j.js.20170502.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20170502.13},
abstract = {Preoperative assessment of complex fistula-in-ano (FIA) is crucial for decision making. Magnetic resonance imaging (MRI) has been used for assessment of perianal sepsis with various protocols and methods. The aim of the present study was to assess the concordance between MRI fistulography with gadopentate enhancement and the intraoperative surgical findings, and to study the impact of preoperative assessment with MRI on surgical outcomes including fistula recurrence and fecal incontinence (FI). Patients with complex and high FIA who were investigated by MRI fistulography preoperatively were reviewed. The concordance between the findings of MRI and the intraoperative findings on examination under anesthesia (EUA) was made using Kappa coefficient test. The accuracy and sensitivity of MRI were calculated regrading detection of the internal opening, primary and secondary fistula tracts. 95 patients (82% males) were included in the study. MRI fistulography had an accuracy of 89.4%, 96.8%, 96.8%, 98%, and 98% in detection of the internal opening, number of tracts, position of primary tract, secondary extensions, and presence of abscess cavities, respectively. Overall, there was very good concordance between MRI and EUA regarding the examined parameters (k= 0.847, 0.937, 0.908, 0.953, 0.957), respectively. Fistula recurrence and minor FI were recorded in 4.2% and 14.7% of patients. MRI fistulography is an effective diagnostic modality for the preoperative assessment of FIA. MRI had excellent accuracy and sensitivity in detection of the internal opening, primary tract, and secondary extensions of anal fistula with very good concordance with the intraoperative findings.},
year = {2017}
}
TY - JOUR T1 - Role of MRI Fistulography with Gadopentate Enhancement in Assessment of Complex Anal Fistulas and Improving Surgical Outcomes AU - Mahmoud Abdelnaby AU - Sameh Hany Emile AU - Ahmad Sakr AU - Alaa Magdy AU - ElYamani Fouda AU - Ahmed Abdel Mawla Y1 - 2017/04/10 PY - 2017 N1 - https://doi.org/10.11648/j.js.20170502.13 DO - 10.11648/j.js.20170502.13 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 22 EP - 27 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20170502.13 AB - Preoperative assessment of complex fistula-in-ano (FIA) is crucial for decision making. Magnetic resonance imaging (MRI) has been used for assessment of perianal sepsis with various protocols and methods. The aim of the present study was to assess the concordance between MRI fistulography with gadopentate enhancement and the intraoperative surgical findings, and to study the impact of preoperative assessment with MRI on surgical outcomes including fistula recurrence and fecal incontinence (FI). Patients with complex and high FIA who were investigated by MRI fistulography preoperatively were reviewed. The concordance between the findings of MRI and the intraoperative findings on examination under anesthesia (EUA) was made using Kappa coefficient test. The accuracy and sensitivity of MRI were calculated regrading detection of the internal opening, primary and secondary fistula tracts. 95 patients (82% males) were included in the study. MRI fistulography had an accuracy of 89.4%, 96.8%, 96.8%, 98%, and 98% in detection of the internal opening, number of tracts, position of primary tract, secondary extensions, and presence of abscess cavities, respectively. Overall, there was very good concordance between MRI and EUA regarding the examined parameters (k= 0.847, 0.937, 0.908, 0.953, 0.957), respectively. Fistula recurrence and minor FI were recorded in 4.2% and 14.7% of patients. MRI fistulography is an effective diagnostic modality for the preoperative assessment of FIA. MRI had excellent accuracy and sensitivity in detection of the internal opening, primary tract, and secondary extensions of anal fistula with very good concordance with the intraoperative findings. VL - 5 IS - 2 ER -
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