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Abdominal Radiology

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01-04-2019 | Review

Structured reporting of MRI for perianal fistula

Authors: Seng Thipphavong, Andreu F. Costa, Hamideh Ale Ali, David Chenhan Wang, Mantaj S. Brar, Kartik S. Jhaveri

Published in: Abdominal Radiology | Issue 4/2019

Abstract

Objective

The purpose of this article is to review MRI technique, relevant anatomy, and MRI classification systems for the assessment of perianal fistulising disease. We present a stepwise approach to the assessment of perianal fistulas on MRI utilizing a systematic reporting format.

Conclusion

MRI is invaluable for the assessment of perianal fistulas. A systematic report can help communicate the anatomy of complex fistulising disease to assist with optimal management.

European Society of Radiology (2018) ESR paper on structured reporting in radiology. Insights Imaging 9:1–7. https://doi.org/10.1007/s13244-017-0588-8 CrossRef

Poullos PD, Tseng JJ, Melcher ML, et al. (2018) Structured reporting of multiphasic CT for Hepatocellular Carcinoma: effect on Staging and Suitability for Transplant. Am J Roentgenol. 210:766–774. https://doi.org/10.2214/AJR.17.18725 CrossRef

Wildman-Tobriner B, Allen BC, Bashir MR, et al. (2017) Structured reporting of CT enterography for inflammatory bowel disease: effect on key feature reporting, accuracy across training levels, and subjective assessment of disease by referring physicians. Abdom Radiol (NY) 42:2243–2250. https://doi.org/10.1007/s00261-017-1136-1 CrossRef

Lather JD, Che Z, Saltzman B, Bieszczad J (2018) Structured Reporting in the Academic Setting: What the Referring Clinician Wants. J Am Coll Radiol . https://doi.org/10.1016/j.jacr.2017.12.031 PubMedCrossRef

de Miguel Criado J, del Salto LG, Rivas PF, del Hoyo LF, Velasco LG, de las Vacas MI, Marco Sanz AG, Paradela MM, Moreno EF (2012) MR imaging evaluation of perianal fistulas: spectrum of imaging features. Radiographics 32:175-94, https://doi.org/10.1148/rg.321115040

Tolan DJ (2016) Magnetic Resonance Imaging for Perianal Fistula. Semin Ultrasound CT MR 37:313–322. https://doi.org/10.1053/j.sult.2016.04.004 CrossRefPubMed

Szurowska E, Wypych J, Izycka-Swieszewska E (2007) Perianal fistulas in Crohn’s disease: mRI diagnosis and surgical planning: MRI in fistulazing perianal Crohn’s disease. Abdom Imaging 32:705–718. https://doi.org/10.1007/s00261-007-9188-2 CrossRefPubMed

Hellers G, Bergstrand O, Ewerth S, Holmström B (1980) Occurrence and outcome after primary treatment of anal fistulae in Crohn’s disease. Gut 21:525–527CrossRefPubMedPubMedCentral

Sheedy SP, Bruining DH, Dozois EJ, Faubion WA, Fletcher JG (2017) MR Imaging of Perianal Crohn Disease. Radiology 282:628–645. https://doi.org/10.1148/radiol.2016151491 CrossRefPubMed

10.

Schwartz DA, Wiersema MJ, Dudiak KM, et al. (2001) A comparison of endoscopic ultrasound, magnetic resonance imaging, and exam under anesthesia for evaluation of Crohn’s perianal fistulas. Gastroenterology 121:1064–1072CrossRefPubMed

11.

Beets-Tan RG, Beets GL, van der Hoop AG, et al. (2001) Preoperative MR imaging of anal fistulas: does it really help the surgeon? Radiology 218:75–84. https://doi.org/10.1148/radiology.218.1.r01dc0575 CrossRefPubMed

12.

Mahjoubi B, Haizadch Kharazi H, Mirzaei R, Moghimi A, Changizi A (2006) Diagnostic accuracy of body coil MRI in describing the characteristics of perianal fistulas. Colorectal Dis 8:202–207. https://doi.org/10.1111/j.1463-1318.2005.00899.x CrossRefPubMed

13.

Singh K, Singh N, Thukral C, Singh KP, Bhalla V (2014) Magnetic resonance imaging (MRI) evaluation of perianal fistulae with surgical correlation. J Clin Diagn Res 8:RC01-4. https://doi.org/10.7860/JCDR/2014/7328.4417 CrossRefPubMed

14.

Siddiqui MR, Ashrafian H, Tozer P, et al. (2012) A diagnostic accuracy meta-analysis of endoanal ultrasound and MRI for perianal fistula assessment. Dis Colon Rectum 55:576–585. https://doi.org/10.1097/DCR.0b013e318249d26c CrossRefPubMed

15.

Gustafsson UM, Kahvecioglu B, Aström G, Ahlström H, Graf W (2001) Endoanal ultrasound or magnetic resonance imaging for preoperative assessment of anal fistula: a comparative study. Colorectal Dis 3:189–197CrossRefPubMed

16.

Hori M, Oto A, Orrin S, Suzuki K, Baron RL (2009) Diffusion-weighted MRI: a new tool for the diagnosis of fistula in ano. J Magn Reson Imaging 30:1021–1026. https://doi.org/10.1002/jmri.21934 CrossRefPubMed

17.

Yoshizako T, Kitagaki H (2013) A pictorial review of the impact of adding diffusion-weighted MR imaging to other MR sequences for assessment of anal fistulae. Jpn J Radiol 31:371–376. https://doi.org/10.1007/s11604-013-0204-x CrossRefPubMed

18.

Dohan A, Eveno C, Oprea R, et al. (2014) Diffusion-weighted MR imaging for the diagnosis of abscess complicating fistula-in-ano: preliminary experience. Eur Radiol 24:2906–2915. https://doi.org/10.1007/s00330-014-3302-y CrossRefPubMed

19.

Parks AG, Gordon PH, Hardcastle JD (1976) A classification of fistula-in-ano. Br J Surg 63:1–12CrossRefPubMed

20.

Marks CG, Ritchie JK (1977) Anal fistulas at St Mark’s Hospital. Br J Surg 64:84–91CrossRefPubMed

21.

Halligan S, Stoker J (2006) Imaging of fistula in ano. Radiology 239:18–33. https://doi.org/10.1148/radiol.2391041043 CrossRefPubMed

22.

Morris J, Spencer JA, Ambrose NS (2000) MR imaging classification of perianal fistulas and its implications for patient management. Radiographics 20:623–635. https://doi.org/10.1148/radiographics.20.3.g00mc15623 CrossRefPubMed

23.

Van Assche G, Vanbeckevoort D, Bielen D, et al. (2003) Magnetic resonance imaging of the effects of infliximab on perianal fistulizing Crohn’s disease. Am J Gastroenterol 98:332–339. https://doi.org/10.1111/j.1572-0241.2003.07241.x CrossRefPubMed

24.

Jayarajah U, Samarasekera DN (2017) Predictive accuracy of Goodsall’s rule for fistula-in-ano. Ceylon Med J 62:97–99. https://doi.org/10.4038/cmj.v62i2.8474 CrossRefPubMed

25.

Beaulieu R, Bonekamp D, Sandone C, Gearhart S (2013) Fistula-in-ano: when to cut, tie, plug, or sew. J Gastrointest Surg. 17:1143–1152. https://doi.org/10.1007/s11605-012-2126-9 CrossRefPubMed

26.

Vogel JD, Johnson EK, Morris AM, Paquette IM, Saclarides TJ, Feingold DL, Steele SR. Dis Colon Rectum. 59:1117–1133

27.

Schroder O, Blumenstein I, Schulte-Bockholt A, Stein J (2004) Combining infliximab and methotrexate in fistulizing Crohn’s disease resistant or intolerant to azathioprine. Aliment Pharmacol Ther. 19:295–301CrossRefPubMed

Title: Structured reporting of MRI for perianal fistula
Authors: Seng Thipphavong
Andreu F. Costa
Hamideh Ale Ali
David Chenhan Wang
Mantaj S. Brar
Kartik S. Jhaveri
Publication date: 01-04-2019
Publisher: Springer US
Published in: Abdominal Radiology / Issue 4/2019
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-018-1839-y

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Abstract

Objective

Conclusion

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