Role of MRI in Perianal Fistula

This study aims to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) in the preoperative assessment of anal fistula. MRI has become an essential imaging modality for the evaluation of perianal fistulous disease due to its superior soft-tissue contrast and ability to delineate fistulous tracts, internal openings, secondary extensions, and associated abscesses.

Patients clinically suspected of having anal fistula and scheduled for surgical management will undergo preoperative MRI examination. The MRI protocol will include multiplanar T1-weighted and T2-weighted sequences, with or without fat suppression, to accurately identify the primary fistulous tract, internal opening, secondary ramifications, and any associated collections.

MRI findings will be recorded and classified according to standard fistula classification systems. These findings will then be compared with intraoperative surgical findings, which will be considered the reference standard.

The primary objective of this study is to determine the diagnostic accuracy of MRI in identifying the primary tract, internal opening, secondary extensions, and associated abscesses. Secondary objectives include assessing the role of MRI in preoperative planning and evaluating its ability to reduce recurrence rates through better delineation of fistulous anatomy.

The results of this study may contribute to improving preoperative evaluation strategies and optimizing surgical management in patients with perianal fistula.

• Diagnostic imaging (MRI) (Other): MRI is performed as apart of peri-operative assessment of perianal fistula, This is not therapeutic intervention.

Primary outcomes

• Diagnostic accuracy of MRI in assessment of perianal fistula [Preoperative MRI assessment performed within 2 weeks before surgery.]: Evaluation of the diagnostic accuracy of magnetic resonance imaging (MRI) in detecting and classifying perianal fistulas and associated complications. MRI findings will be compared with surgical findings as the reference standard to determine sensitivity, specificity, and overall diagnostic performance.

Sex: All

Inclusion Criteria:

* Patients clinically diagnosed or suspected to have perianal fistula.
* Both male and female patients of any age group
* Patients referred for preoperative MRI assessment prior to surgical management.

Exclusion Criteria:

* Patients with contraindications to MRI, such as pacemakers, metallic implants, or severe claustrophobia.
* Patients refusing to participate in the study.

• Nahla Mohamed Ali, MD, Principal investigator, unaffillated