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The comparison of CT fistulography and MR imaging of perianal fistulae with surgical findings: a case–control study

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Abstract

Purpose

The purpose of this study was to evaluate the diagnostic efficacies of CT fistulography and MRI, in the diagnostic work-up of perianal fistula patients.

Materials and methods

All 41 patients who were included in the study (36 males and 5 females, with an average age of 41 years) underwent CT fistulography and MRI examinations prior to surgery. The fistula characteristics obtained from these examinations were compared with the surgical findings. The comparative results were evaluated by means of the Kappa analysis method.

Results

CT fistulography predicted the correct perianal fistula classification in 30 (73.1%) of the 41 patients, whereas MRI correctly defined fistula classification in 38 (92.7%) of these patients (the K values were 0.621 and 0.896, respectively; with p < 0.001). CT fistulography depicted 29 secondary extensions in 16 patients, whereas MR imaging revealed 28 secondary extensions in 15 patients. A substantial agreement was found between surgical findings and two modalities (K value was 0.789 and 0.793 for CT fistulography and MRI, respectively, with a p value < 0.001). In terms of locations of internal openings, CT fistulography was able to detect the locations in 28 patients (68.2%), whereas MRI was more successful in this aspect, with a number of 35 patients (85.3%). Granulation tissues, inflammation and edema around the fistula, abscesses, and fistular wall fibrosis were also evaluated.

Conclusion

CT fistulography and MRI have different advantages in the diagnosis of perianal fistulas. A good command of knowledge concerning the issue may be a key factor in modality decision.

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Authors and Affiliations

  1. Department of Radiology, Numune Teaching and Research Hospital, Ege bagatur Bulvari Serinevler Yüreğir, Adana, Turkey

    Gokhan Soker, Bozkurt Gulek, Cengiz Yilmaz, Omer Kaya, Muhammet Arslan & Okan Dilek

  2. Department of General Surgery, Numune Teaching and Research Hospital, Adana, Turkey

    Mustafa Gorur & Oktay İrkorucu

  3. Department of Infectious Diseases and Clinical Microbiology, Cukurova University, Adana, Turkey

    Ferit Kuscu

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  1. Gokhan Soker
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Correspondence to Gokhan Soker.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Soker, G., Gulek, B., Yilmaz, C. et al. The comparison of CT fistulography and MR imaging of perianal fistulae with surgical findings: a case–control study. Abdom Radiol 41, 1474–1483 (2016). https://doi.org/10.1007/s00261-016-0722-y

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