Abstract
Objective
To prospectively evaluate the relative accuracy of computed tomography (CT) fistulography
for preoperative assessment of fistula in ano.
Materials and Methods
Ethical committee approval and informed consent were obtained. A total of 22 patients
(15 male and 7 female, age 21–58 years) who were suspected of having fistula in ano
underwent preoperative CT fistulography (CTF). The CT images of 0.6 mm were obtained
respectively before and after fistulography; contrast-enhanced CT scan was also performed
in 22 patients. CTF images were evaluated by two expert radiologists to assess the
fistulas in the following respects: (a) the volume-rendered imaging; (b) the extensions
of active inflammatory tissue; (c) the internal opening and external opening; (d)
the hidden areas of tract or abscess; and (e) the deep abscess adjacent to fistula.
CT findings in 18 patients were compared with surgical findings or exam under anesthesia.
Results
The CTF findings in 18 cases were basically in accordance with the surgical findings
and/or examination findings under anesthesia. Both coronal and transverse planes were
useful in assessing the location and direction of tracts or abscesses. Complicated
spatial information within the perianal soft tissue about the fistula with secondary
ramifications or abscesses can be easily demonstrated to the surgeons. Contrast-enhanced
images were useful in assessing the inflammatory lesion activity and infiltrated area.
Conclusion
CTF exquisitely depicts the perianal anatomy and shows the fistulous tracks with their
associated ramifications, enables selection of the most appropriate surgical treatment,
and therefore minimizes all chances of recurrence.
Keywords
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Article info
Publication history
Published online: August 19, 2013
Accepted:
April 12,
2013
Received in revised form:
February 18,
2013
Received:
October 19,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
