International Journal of Colorectal Disease

, Volume 15, Issue 5, pp 317–322

Magnetic resonance imaging with rectal Gd-DTPA: new tool for the diagnosis of perianal fistula

  • Nuran Sabir
  • Uğur Sungurtekin
  • Ergün Erdem
  • Mehmet Nessar
Original Article

DOI: 10.1007/s003840000251

Cite this article as:
Sabir, N., Sungurtekin, U., Erdem, E. et al. Int J Colorectal Dis (2000) 15: 317. doi:10.1007/s003840000251

Abstract.

This study investigated the effectiveness of magnetic resonance imaging (MRI) with rectal administration of the enteral contrast agent gadolinium diethylene triamine pentaacetic acid (Gd-DTPA) in the diagnosis of recurrent perianal fistulae, assessing the number, anatomical extent, location, and signal intensities of various lesions. Fistulas were examined by MRI before and after rectal administration of Gd-DTPA in 50 patients (excluding fistulas due to inflammatory bowel disease). Surgical findings were compared with both pre- and postcontrast T1-weighted, T2-weighted, and short T1 inversion recovery (STIR) sequences. Of the 68 fistulous tracts detected surgically, precontrast imaging identified 16 by T1-weighted images (hypointense), 27 by T2-weighted images (hyperintense or iso- to weakly hyperintense), and 54 by STIR. Postcontrast imaging identified 29 by T1-weighted images, 58 by T2-weighted, and 54 by STIR. MRI with rectal administration of Gd-DTPA thus facilitates determination of fistula tracts, which are better resolved by precontrast STIR than by either precontrast T1- or T2-weighted images. Postcontrast T2-weighted images were substantially superior to T1-weighted. Both noncontrast STIR and postcontrast T2-weighted sequences were adequate for classifying fistulas in ano, but in complex recurrent anal fistula postcontrast T2-weighted images were more helpful.

Perianal fistula Rectal Gd-DTPA administration Magnetic resonance imaging

Copyright information

© Springer-Verlag 2000

Authors and Affiliations

  • Nuran Sabir
    • 1
  • Uğur Sungurtekin
    • 2
  • Ergün Erdem
    • 2
  • Mehmet Nessar
    • 2
  1. 1.Department of Radiology, Pamukkale University School of Medicine, Denizli, Turkey
  2. 2.Department of Surgery, Pamukkale University School of Medicine, Tokat caddesi no: 41 D: 8, 20020 Denizli, Turkey