Reza SeyedSadjadi MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: The purpose of this study was to compare different imaging modalities in the evaluation of patients with recurrent anorectal fistulas. Methods and Materials: Twenty-nine patients (20 men, 9 women; age range 23-67 years; mean age 40 years) with recurrent anorectal fistulas with preceding endoanal sonography (EAS), pelvic MR imaging, and endoanal MR imaging examinations performed during a 10-month period were prospectively selected for the study. Four patients that could not tolerate coil insertion (N=2) or had severe anal stenosis (N=2) were excluded. Two radiologists in consensus analyzed the images and recorded the following findings: visualization of primary and second tracts, presence or absence of abscesses, internal opening, and horseshoe fistulas. Results: EAS, pelvic MR imaging, and endoanal MR imaging demonstrated 70%, 93%, and 86% anorectal fistulas, respectively. Pelvic MR imaging was the best modality for the identification of primary tracts (sensitivity 96%, specificity 66%, and accuracy 93%). Endoanal MR imaging was the best modality for the detection of the internal opening (sensitivity 92%, specificity 60%, and accuracy 89%), secondary tracts (sensitivity 83%, specificity 100%, and accuracy 93%), and horseshoe fistulas (sensitivity 100%, specificity 78%, and accuracy 100%). All abscesses (N=14) were demonstrated with pelvic MR imaging but EAS and endoanal MR imaging missed 7 and 3 cases, respectively. Conclusion: Endoanal MR imaging is the best modality for the evaluation of patients with recurrent endoanal fistulas. Pelvic MR imaging, however, allows the best characterization of associated abnormalities such as abscesses.       Questions about this event email: perissaabbasoglu@yahoo.com

SeyedSadjadi MD, R, Endorectal Sonography, Pelvic MR Imaging, and Endoanal MR Imaging: A Comparative Prospective Study in the Diagnosis of Recurrent Anorectal Fistula in 29 Surgical Patients.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3108709.html