ABSTRACT
Aim: the management of fistula in-ano has been based on digital examination and operative findings. This study was conducted to asses the diagnostic accuracy of magnetic resonance imaging [MRI] with endorectal coil in perianal fistula
Patients and Methods: twenty patients with anal fistula were classified into two groups. The first one included those who had primary fistula [10 patients] and the second included those with recurrent fistula [10 patients]. All patients underwent preoperative MR imaging using endorectal coil. The findings were compared to examination under anesthesia [ELIA] and final surgical findings
Results: comparing MRI with operative data [EUA and final surgical results]; in the first group with simple fistula, MR imaging showed additional information than examination under anesthesia in only one patient [10%] and did not diagnose one fistulous tract at all. 111 the second group, MRI detected 8 internal openings correctly and one opening was missed. MRI added information than EUA in 6 patients, its fallacies was noted in 2 patients
Conclusion: MRI with endorectal coil could be very useful and reliable in defining fistula anatomy, assessing relationship with anal sphincter, identifying secondary extensions [particularly horseshoe tracts] and planning surgical strategy