T2 weighted image showing well defined linier hyperintense tract in the 12 o' clock position of the perianal region terminating in the trans sphincteric plane (arrow) suggestive of grade 3 trans sphincteric fistula. No ramification or abscess formation.
T2 Fat saturated sagittal image showing the tract (arrow)
Discussion:
Perianal fistulization is an uncommon but important condition of the gastrointestinal tract that causes substantial morbidity. Perianal fistulas occur in approximately 10 of 100,000 persons, with a twofold to fourfold male predominance. Magnetic resonance (MR) imaging has been shown to demonstrate accurately the perianal anatomy.
Grading:
St James's University Hospital MR Imaging Classification of Perianal Fistulas
| Grade | Description |
| 0 | Normal appearance |
| 1 | Simple linear intersphincteric fistula |
| 2 | Intersphincteric fistula with intersphincteric abscess or secondary fistulous track |
| 3 | Trans–sphincteric fistula |
| 4 | Trans–sphincteric fistula with abscess or secondary track within the ischioanal or ischiorectal fossa |
| 5 | Supralevator and translevator disease |
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