Magnetic resonance imaging for fistulography in perianal fistula: clinicoradiological correlation


  • Hitesh Sarda Department of Surgical Gastroenterology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • Anshuman Pandey Department of Surgical Gastroenterology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • Sudip Regmi Department of Surgical Gastroenterology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • Shakeel Masood Department of Surgical Gastroenterology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India



MR fistulography, Perianal Fistula, Concordance


Background: This article aims to review the role of magnetic resonance imaging (MRI) fistulography in evaluation of perianal fistula along with its concordance with clinical examination and impact on surgical intervention.

Methods: A retrospective study of 61 patients who underwent surgery for anal fistula in RMLIMS collected from database from January 1, 2017 to September, 2021

Results: The study showed a significant MRI contribution to clinical evaluation in 65.6%. MRI provided significant information for complex fistu­las than for simple fistulas (45% vs. 14.6%, p=0.01). Proportion of patients with sig­nificant MRI contribution increased with in­creasing Parks grade (grade 1, 8.3%; grade 2, 52.2%, p=0.001). The concordance between St. James Hos­pital grade and Parks classification was 0.768 (Kappa coefficient, p<0.00).

Conclusions: Therefore, we propose inclusion of MRI in the preoperative surgical assessment of anal fistulas when recurrent, complex, high grade, or when the external opening is located more than 2 cm from the anal canal.


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Original Research Articles