当前位置： SCI文献检索 > RADIOLOGY期刊下所有文献 > Anovaginal fistulas: evaluation with endoanal MR imaging.

Anovaginal fistulas: evaluation with endoanal MR imaging.

Abstract：

PURPOSE:To evaluate endoanal magnetic resonance (MR) imaging in the assessment of anovaginal fistulas and associated findings. MATERIALS AND METHODS:In a retrospective descriptive study, two radiologists systematically reviewed MR findings in 20 patients with a clinically proved anovaginal fistula and looked for the main fistula tract, the internal opening in the anal canal and/or vagina, secondary fistula tracts, abscesses within the rectovaginal septum, and sphincter damage. Interobserver variability was calculated, and clinical records were searched for possible underlying causes that could explain the complexity of anovaginal fistulas. The kappa value was calculated. Patients with or without a complex anovaginal fistula were compared in regard to the presence of any underlying disease or condition. Statistical significance was calculated with the Fisher exact test. RESULTS:In all 20 patients, anovaginal fistulas were identified on T2-weighted MR images as predominantly high-signal-intensity linear abnormalities extending between the anal canal and the vagina. In all patients, the fistulas were typically located in the sagittal plane, and the mean distance from the anal verge to the fistula was 25.0 mm (range, 13-32 mm). The internal opening in the anal canal was detected in all patients. The internal opening in the vagina was detected in 19 (95%) patients. In seven (35%) patients, an anovaginal fistula with an additional abnormality was found and included an abscess within the rectovaginal septum (n = 1), a perianal fistula (n = 3), and a perianal fistula in combination with an abscess (n = 3). Defects of the external anal sphincter were present in three (15%) patients. There was complete agreement between observers for all items on endoanal MR images, except for the presence of secondary fistula extensions (agreement, 90%; kappa, 0.74). History of obstetric trauma, pelvic floor surgery, or Crohn disease was present in 10 (50%) patients. Of these patients, six (60%) had a complex anovaginal fistula and four (40%) had a simple anovaginal fistula. In the remaining 10 patients without relevant medical history, one (10%) had a complex anovaginal fistula. This difference tended toward statistical significance (P =.057). CONCLUSION:Endoanal MR imaging allows evaluation of anovaginal fistulas and additional abnormalities, such as abscesses within the rectovaginal septum, secondary perianal fistula tracts, and sphincter damage.

journal_name

Radiology

journal_title

Radiology

authors

Dwarkasing S,Hussain SM,Hop WC,Krestin GP

doi

10.1148/radiol.2311021190

subject

Has Abstract

pub_date

2004-04-01 00:00:00

pages

123-8

issue

eissn

0033-8419

issn

1527-1315

pii

231/1/123

journal_volume

231

pub_type

杂志文章

在线工具

Anovaginal fistulas: evaluation with endoanal MR imaging.