THE ROLE OF MAGNETIC RESONANCE IMAGING IN PREOPERATIVE EVALUATION OF PERIANAL FISTULA

Abstract

Background: Magnetic resonance imaging (MRI) has become the preferred method for examining perianal fistulas before surgery. This study aimed to evaluate how well MRI can identify different types and severities of perianal fistulas, compare these findings to what was observed during surgery, and determine if MRI can help prevent problems after surgery. Materials and Methods: This study examined the accuracy of MR fistulography in predicting the location and extent of perianal fistulas in 110 patients. The study compared MR fistulography findings with surgical outcomes over 18 months. Results: MRI demonstrated strong concordance with surgical findings in the evaluation of perianal fistulas. The imaging modality accurately identified primary and branched tracts, abscesses, and horseshoe components. Additionally, MRI exhibited high sensitivity (96%), specificity (83%), and positive predictive value (94.5%) for detecting internal openings. Preoperative MRI assessment was associated with a reduced risk of fistula recurrence. Conclusion: Preoperative magnetic resonance fistulography improves diagnostic accuracy in the assessment of fistulous tract anatomy. It precisely delineates the fistula's location in relation to the anal sphincters, accurately identifies internal openings, branch tracts, abscesses, and horseshoe formations. This also contributes to a reduction in postoperative recurrence.