Role of MRI with endorectal coil in management of perianal fistula

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

DNA flow cytometry in colorictal carcinomas: experiences in tumors from Egypt

Colorectal carcinoma occurs at a much lower frequency in Egypt than in western countries. In this study of forty colorectal carcinomas we investigated the prognostic value of flow cytometric ploidy and S- phase measurements together with various morphological characteristics of the tumors. Repeated measurements of 324 paraffin - embedded or fresh samples from the 40 tumors demonstrated the high reproducibility of ploidy and S- phase analysis [r=0.97 and r= 0.89 respectively]. Tumor heterogeneity showing diploid and aneuploid cell population or aneuploid cell populations with various ploidy values by measuring a mean of 4.6 samples /tumor was found in 40%, while the proportion of aneuploid tumors increased significantly with grade but not with stage of the tumors. The% S-phase cells correlated with grade but not with the stage. After a follow up of 24 months, in the Kaplan Meire univariate Analysis, the following factors had a prognostic value, staging [P=0.005]. ploidy level [P=0.0018],% S-phase [P=0.0006], histopathological types [P=0.01], grading [P=0.05]. Multivariate Analysis using Cox's proportional Hazanl model revealed independent prognostic value for Dukes' stage [P=0.02], and ploidy level [P=0.05]