MRI of perianal fistula

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Author: Rodrigo Castilhos [notes 1]

Epidemiology

  • Uncommon condition
  • High morbitidy
  • Men (2:1)
  • Young adults

Technique

  • Edema sequences: STIR, T2 FS
  • Enhancement sequence: T1 FS

Classification

St. Jame's classification

  • Type 1: simple linear intersphincteric fistula
  • Type 2: intersphincteric fistula with abscess or secondary tract
  • Type 3: trans-sphincteric fistula
  • Type 4: trans-sphincteric fistula with formation of abscess or secondary tract within the ischioanal fossa
  • Type 5: suprasphincteric or extrasphincteric fistula

Complexity

  • Simple
  • Complex

Characteristics

  • Internal opening: location (clock), high vs low.
  • External opening: location (clock), location (perineum, natal cleft), distance to anal margin
  • Involvement of other structures

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.

References