Introduction: Fistula-in-ano is a common condition in which the accurate anatomy of the fistula is essential in the surgical management. Inadequate assessment may lead to recurrence, multiple unnecessary operation and may also render the patient incontinent. Methods and Material: Patients with clinical evidence or clinical suspicion of perianal fistulas underwent pelvic MRI performed with phased-array coil(1.5T). Images were obtained in the coronal and axial planes using FSE T1 and T2 sequences with and without fat suppression. As radiologists we should answer 2 key questions that the surgeon is interested in knowing: 1. The anatomic location of the primary fistula and any secondary extension, including abscesses. 2. The relationship of the fistula to the levator complex. Results and Conclusion: MRI is an accurate technique to map the anal and perianal fistulas. More over with the multiplanar capabilities and high contrast resolution, MRI shows the surgical anatomy accurately and identifies complex fistulas. MRI is helpful in preoperative evaluation of fistulas, thereby able to predict the surgical outcomes and reduce the recurrence rates.
Upon review of this exhibit the reader will be able to: 1) Discuss the classification of fistula-in-ano. 2) Understand the anatomy and MRI features of different types of Fistula-in-Ano. 3) Recognize the role of MRI in the diagnosis and preoperative staging.
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