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Comparison of contrast-enhanced fat-suppressed T1-3D-VIBE and T1-TSE MRI in evaluating anal fistula

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Abstract

Objective

To evaluate the accuracy of contrast-enhanced (CE) fat-suppressed three-dimensional (3D) T1-weighted imaging with volumetric interpolated breath-hold examination (FS-T1-3D-VIBE) and fat-suppressed T1-weighted turbo spin echo (FS-T1-TSE) sequence in characteristics of anal fistula.

Methods

One hundred and two patients underwent perianal CE-MRI examination on a 3T scanner including FS-T1-3D-VIBE and FS-T1-TSE sequences before surgery. The performance of each sequence was evaluated in terms of fistula classification, clarity of internal opening, number and position of internal openings including the distance between internal opening and anal verge, presence of secondary tracts and blind-ending sinus tracts. MRI findings were compared with surgical findings. Signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) of fistula, gluteus maximus, and subcutaneous fat were compared between CE FS-T1-TSE and CE FS-T1-3D-VIBE.

Results

Compared with CE FS-T1-TSE, CE FS-T1-3D-VIBE displayed more accurate in secondary tract, lithotomy position of the internal opening and the distance between internal opening and anal verge (P < 0.05). CE FS-T1-3D-VIBE was found superior to CE FS-T1-TSE in the clarity of the internal openings and in the diagnostic accuracy of blind-ending sinus tracts and complex fistulas in Standard Practice Task Force classification (P < 0.05). CE FS-T1-3D-VIBE achieved higher SNRs and CNRs in fistula and gluteus maximus than CE FS-T1-TSE (P ≤ 0.001).

Conclusion

CE-MRI of FS-T1-3D-VIBE might be a more valuable noninvasive technique than FS-T1-TSE to evaluate the anal fistula on evaluating the lithotomy position of internal opening, distance between internal opening and anal verge, clarity of internal opening, secondary tract, blind-ending sinus tract and classification of the complex fistula.

The trial registration number for this prospective trial was Chi-TR1800020206 and the trial registration date was December 20, 2018.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

Dr. Hualing Song from Shanghai University of Traditional Chinese Medicine provided statistical advice for this study.

Funding

This research received funding from Shanghai ‘Rising Stars of Medical Talent’ Youth Development Program Youth Medical Talents—Medical Imaging Practitioner Program [No. SHWRS (2020)-087], Science and Technology Commission of Shanghai Municipality (No. 19401933900), Clinical Research Plan of SHDC (No. SHDC2020CR2007A).

Author information

Authors and Affiliations

  1. Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, 528 Zhang-heng Road, Shanghai, 201203, People’s Republic of China

    Jianxi Zhao, Fang Lu, Zhigang Gong, Yanwen Huang & Songhua Zhan

  2. Department of Colorectal Surgery, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People’s Republic of China

    Qingming Wang, Hong Lu & Wei Yang

  3. MR Scientific Marketing, Siemens Healthcare, Shanghai, 201318, People’s Republic of China

    Mengxiao Liu & Zhongshuai Zhang

  4. Department of Radiology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Middle Zhi-jiang Road, Shanghai, 200071, People’s Republic of China

    Shuohui Yang

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  1. Jianxi Zhao
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  2. Fang Lu
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  3. Qingming Wang
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  4. Hong Lu
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  8. Yanwen Huang
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  9. Wei Yang
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  10. Songhua Zhan
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by JZ and FL. The first draft of the manuscript was written by JZ. The manuscript was revised by SY and SZ. MRI technology was supported by YH, ZG, ZZ, and ML. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Songhua Zhan or Shuohui Yang.

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Conflict of interest

Financial interests: Mengxiao Liu and Zhongshuai Zhang are employed by Siemens Healthcare and provided MR technical support for this study under a Siemens collaboration agreement. They did not receive payment for participating in the study and had no personal motivation for the study outcome. The other authors of this manuscript have no financial interests.

Non-financial interests: none.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board (identification number: 2018-636-67-01) 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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Zhao, J., Lu, F., Wang, Q. et al. Comparison of contrast-enhanced fat-suppressed T1-3D-VIBE and T1-TSE MRI in evaluating anal fistula. Abdom Radiol 47, 3688–3697 (2022). https://doi.org/10.1007/s00261-022-03661-8

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