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Direct MRI fistulography with hydrogen peroxide in patients with recurrent perianal fistulas: a new proposal of extended diagnostics.

Waniczek D, Adamczyk T, Arendt J, Kluczewska E - Med. Sci. Monit. (2015)

Bottom Line: The study group consisted of 12 subjects operated on from 2011.Direct HPMRI fistulography was performed in all subjects before the operation.In 1 case, an internal opening was not found.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery Propedeutics, Clinical Department of General, Colorectal and Trauma Surgery, Medical University of Silesia, Sosnowiec, Poland.

ABSTRACT

Background: Perianal fistulas are malformations of the anorectal area. Accurate preoperative assessment of perianal fistula tract is a main assumption in diagnosis of the disease, affecting the operation efficiency. The aim of the study was to present our experience in application of a new diagnostic protocol based on the magnetic resonance imaging (MRI) examination using a mixture of hydrogen peroxide (HP) and gadolinium as a direct contrast medium in evaluation of recurrent fistulas tract. The method is referred to as HPMRI.

Material and methods: The study group consisted of 12 subjects operated on from 2011. Direct HPMRI fistulography was performed in all subjects before the operation. All types of fistulas were precisely evaluated by HPMRI examination.

Results: Intraoperative state confirmed complete course of fistulas in 11 cases. In 1 case, an internal opening was not found.

Conclusions: We suggest that this new method of direct HPMRI fistulography may improve visualization of the tracts of recurrent fistulas and improve efficacy of surgical procedures.

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Related in: MedlinePlus

Direct HPMRI fistulography, axial plane, T1 weighted image with fat saturation. Extrasphincteric perianal fistula on the left side. Lumen filed with mixture of HP and gadolinium (Gadovist) – “double-barrel effect”.
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f6-medscimonit-21-439: Direct HPMRI fistulography, axial plane, T1 weighted image with fat saturation. Extrasphincteric perianal fistula on the left side. Lumen filed with mixture of HP and gadolinium (Gadovist) – “double-barrel effect”.

Mentions: HPMRI has been used since 2011. The procedure of the examination has not changed, but short-term pain and spreading sensation was reported by 3 patients during contrast administration into the external opening of the fistula. Slower contrast administration allowed reduction of those minor complaints. We stress the much easier evaluation of the fistula canal, due to the “double-barrel effect” (Figures 6 and 7).


Direct MRI fistulography with hydrogen peroxide in patients with recurrent perianal fistulas: a new proposal of extended diagnostics.

Waniczek D, Adamczyk T, Arendt J, Kluczewska E - Med. Sci. Monit. (2015)

Direct HPMRI fistulography, axial plane, T1 weighted image with fat saturation. Extrasphincteric perianal fistula on the left side. Lumen filed with mixture of HP and gadolinium (Gadovist) – “double-barrel effect”.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4334356&req=5

f6-medscimonit-21-439: Direct HPMRI fistulography, axial plane, T1 weighted image with fat saturation. Extrasphincteric perianal fistula on the left side. Lumen filed with mixture of HP and gadolinium (Gadovist) – “double-barrel effect”.
Mentions: HPMRI has been used since 2011. The procedure of the examination has not changed, but short-term pain and spreading sensation was reported by 3 patients during contrast administration into the external opening of the fistula. Slower contrast administration allowed reduction of those minor complaints. We stress the much easier evaluation of the fistula canal, due to the “double-barrel effect” (Figures 6 and 7).

Bottom Line: The study group consisted of 12 subjects operated on from 2011.Direct HPMRI fistulography was performed in all subjects before the operation.In 1 case, an internal opening was not found.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery Propedeutics, Clinical Department of General, Colorectal and Trauma Surgery, Medical University of Silesia, Sosnowiec, Poland.

ABSTRACT

Background: Perianal fistulas are malformations of the anorectal area. Accurate preoperative assessment of perianal fistula tract is a main assumption in diagnosis of the disease, affecting the operation efficiency. The aim of the study was to present our experience in application of a new diagnostic protocol based on the magnetic resonance imaging (MRI) examination using a mixture of hydrogen peroxide (HP) and gadolinium as a direct contrast medium in evaluation of recurrent fistulas tract. The method is referred to as HPMRI.

Material and methods: The study group consisted of 12 subjects operated on from 2011. Direct HPMRI fistulography was performed in all subjects before the operation. All types of fistulas were precisely evaluated by HPMRI examination.

Results: Intraoperative state confirmed complete course of fistulas in 11 cases. In 1 case, an internal opening was not found.

Conclusions: We suggest that this new method of direct HPMRI fistulography may improve visualization of the tracts of recurrent fistulas and improve efficacy of surgical procedures.

Show MeSH
Related in: MedlinePlus