Friday, April 8, 2011

Perianal Fistula - Grade 3


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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