ABSTRACT
Background Anorectal fistulas are chronic inflammations of peri-anal tissues that form a connection between the perineal skin and the anal canal. Accurate preoperative evaluation of the main fistula's trajectory and pelvic tissues is essential for effective surgical treatment of anal fistulas. The inability to detect concealed lesions may result in the recurrence of fistulas and the conversion of a simple fistula into a complex fistula. Magnetic resonance imaging (MRI) imaging can detect concealed pathways and abscesses, thereby exposing the intricate connection between the fistula and anal-sphincter complex. This data serves as a roadmap for making surgical decisions, thereby reducing the likelihood of illness recurrence and complications after surgery. Aim To evaluate the role of MRI in pre-operative assessment of an anorectal fistula, compare its findings with surgical results. Materials and methods The research was conducted at the Radiology Department, Apollo Hospital, Hyderabad. It was a prospective observational study. IBM SPSS Statistics for Windows, Version 17 (released 2008; IBM Corp., Armonk, New York, United States) was utilized for data analysis. The mean and standard deviation were computed. We further applied appropriate statistical tests to determine the significance of MRI features with pre-operative findings. Results MRI accurately detects features like abscesses (sensitivity-100%, specificity-97.06%), secondary tracts of the fistula (sensitivity-93.55%, specificity-94.12%), horseshoe appearance, and supralevator extension (sensitivity-100%, specificity-97.50%, and 97.62%, respectively). Conclusion When comparing our results with intraoperative findings, MRI showed high sensitivity and specificity in detecting abscesses, secondary tracts, horseshoe appearances, and supralevator extensions. Our findings suggest that MRI can offer anatomical and pathological information for the pre-operative care and surgical planning of perianal fistulas.
ABSTRACT
BACKGROUND: A fluid-attenuated inversion recovery (FLAIR) method eliminates the cerebrospinal fluid (CSF) signal, enhancing white matter lesion detection by enhancing the contrast between the lesion and CSF. Three-dimensional (3D) volume acquisition has the advantage of multiplanar reformation of contiguous slices yielding improved signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs). To our knowledge, there are only three studies comparing 3D- and 2D-FLAIR sequences with respect to multiple sclerosis (MS) lesions at 3 tesla. AIMS AND OBJECTIVES: This study aimed to determine the efficiency of 3D-FLAIR in the detection of lesions of multiple sclerosis in terms of spatial and contrast resolutions in comparison with 2D-FLAIR sequences. METHODOLOGY: A total of 75 patients with MS undergoing magnetic resonance imaging (MRI) brain at the Department of Radiology, Krishna Institute of Medical Sciences (KIMS), Secunderabad, Telangana, India. This is an observational comparative study. Independent-samples t-tests were performed in the present study to compare the number of lesions detected. The measured CNR and SNR values were subjected to Mann-Whitney U test. RESULTS: As a result of the 3D-FLAIR, more lesions were found as compared to 2D-FLAIR (p = 0.001). There was a greater CNRs for 3D-FLAIR images than for 2D-FLAIR images (p = 0.001). Lesions, CSF, white matter, and gray matter showed significantly higher SNRs with 3D-FLAIR (p = 0.001). CONCLUSION: 3D-FLAIR has exhibited greater sensitivity in detecting lesions associated with MS when contrasted with the 2D-FLAIR sequence. Significantly more lesions and higher SNRs and CNRs were detected with 3D-FLAIR in contrast to 2D-FLAIR. 3D-FLAIR may be considered the sequence of choice for MS imaging in the future.
ABSTRACT
OBJECTIVE: To evaluate the advantage of a combination of magnetic resonance spectroscopy (MRS) and magnetic resonance imaging (MRI) over MRI in the diagnosis of intracranial mass lesions to differentiate between neoplastic and non-neoplastic lesions and compare them with histopathology and clinical data as gold standard. METHODOLOGY: This was a descriptive cross-sectional study conducted at the Department of Radiology, Apollo Hospital located in Jubilee Hills, Hyderabad. In the present study, a total of 60 patients of all ages with brain masses found through MRI with positive clinical symptoms, regardless of gender, were included. We also involved patients with non-brain cancers suspected of spreading to the brain. RESULT: MRI identified 63% of lesions as neoplastic and 37% as non-neoplastic. Combining MRI and MRS increased accuracy, with 65% of the lesions diagnosed as neoplastic and 35% as non-neoplastic, demonstrating that MRS significantly enhances diagnostic precision compared to MRI alone. CONCLUSION: This study aimed to see how combining MRI and MRS helps diagnose brain masses, comparing with histopathology as the gold standard. MRI alone identified 63% as neoplastic, but MRI with MRS improved accuracy (65%). MRI sensitivity was 87.80%, but combined with MRS, it increased to 92.68%. Thus, the study concluded that the combination of MRI and MRS is more accurate than MRI alone.
