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Multi Detector Computed Tomography Fistulography In Patients of Fistula-in-Ano: An Imaging Collage
Fistula-in-ano, or perianal fistula, is a challenging clinical condition for both diagnosis and treatment. Imaging modalities such as fistulography, anal endosonography, perineal sonography, magnetic resonance imaging (MRI), and computed tomography (CT) are available for its evaluation. MRI is consi...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5894016/ https://www.ncbi.nlm.nih.gov/pubmed/29662582 http://dx.doi.org/10.12659/PJR.901523 |
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author | Bhatt, Shuchi Jain, Bhupendra Kumar Singh, Vikas Kumar |
author_facet | Bhatt, Shuchi Jain, Bhupendra Kumar Singh, Vikas Kumar |
author_sort | Bhatt, Shuchi |
collection | PubMed |
description | Fistula-in-ano, or perianal fistula, is a challenging clinical condition for both diagnosis and treatment. Imaging modalities such as fistulography, anal endosonography, perineal sonography, magnetic resonance imaging (MRI), and computed tomography (CT) are available for its evaluation. MRI is considered as the modality of choice for an accurate delineation of the tract in relation to the sphincter complex and for the detection of associated complications. However, its availability and affordability is always an issue. Moreover, the requirement to obtain multiple sequences to depict the fistula in detail is cumbersome and confusing for the clinicians to interpret. The inability to show the fistula in relation to normal anatomical structures in a single image is also a limitation. Multi detector computed tomography fistulography (MDCTF) is an underutilized technique for defining perianal fistulas. Acquisition of iso-volumetric data sets with instillation of contrast into the fistula delineates the tract and its components. Post-processing with thin sections allows for a generation of good quality images for presentation in various planes (multi-planar reconstructions) and formats (volume rendered technique, maximum intensity projection). MDCTF demonstrates the type of fistula, its extent, whether it is simple or complex, and shows the site of internal opening and associated complications; all in easy to understand images that can be used by the surgeons. Its capability to represent the entire pathology in relation to normal anatomical structures in few images is a definite advantage. MDCTF can be utilized when MRI is contraindicated or not feasible. This pictorial review shares our initial experience with MDCT fistulography in evaluating fistula-in-ano, demonstrates various components of fistulas, and discusses the types of fistulas according to the standard Parks classification. |
format | Online Article Text |
id | pubmed-5894016 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-58940162018-04-16 Multi Detector Computed Tomography Fistulography In Patients of Fistula-in-Ano: An Imaging Collage Bhatt, Shuchi Jain, Bhupendra Kumar Singh, Vikas Kumar Pol J Radiol Review Article Fistula-in-ano, or perianal fistula, is a challenging clinical condition for both diagnosis and treatment. Imaging modalities such as fistulography, anal endosonography, perineal sonography, magnetic resonance imaging (MRI), and computed tomography (CT) are available for its evaluation. MRI is considered as the modality of choice for an accurate delineation of the tract in relation to the sphincter complex and for the detection of associated complications. However, its availability and affordability is always an issue. Moreover, the requirement to obtain multiple sequences to depict the fistula in detail is cumbersome and confusing for the clinicians to interpret. The inability to show the fistula in relation to normal anatomical structures in a single image is also a limitation. Multi detector computed tomography fistulography (MDCTF) is an underutilized technique for defining perianal fistulas. Acquisition of iso-volumetric data sets with instillation of contrast into the fistula delineates the tract and its components. Post-processing with thin sections allows for a generation of good quality images for presentation in various planes (multi-planar reconstructions) and formats (volume rendered technique, maximum intensity projection). MDCTF demonstrates the type of fistula, its extent, whether it is simple or complex, and shows the site of internal opening and associated complications; all in easy to understand images that can be used by the surgeons. Its capability to represent the entire pathology in relation to normal anatomical structures in few images is a definite advantage. MDCTF can be utilized when MRI is contraindicated or not feasible. This pictorial review shares our initial experience with MDCT fistulography in evaluating fistula-in-ano, demonstrates various components of fistulas, and discusses the types of fistulas according to the standard Parks classification. Termedia Publishing House 2017-09-15 /pmc/articles/PMC5894016/ /pubmed/29662582 http://dx.doi.org/10.12659/PJR.901523 Text en Copyright © Polish Medical Society of Radiology 2017 https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0). License allowing third parties to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially. |
spellingShingle | Review Article Bhatt, Shuchi Jain, Bhupendra Kumar Singh, Vikas Kumar Multi Detector Computed Tomography Fistulography In Patients of Fistula-in-Ano: An Imaging Collage |
title | Multi Detector Computed Tomography Fistulography In Patients of Fistula-in-Ano: An Imaging Collage |
title_full | Multi Detector Computed Tomography Fistulography In Patients of Fistula-in-Ano: An Imaging Collage |
title_fullStr | Multi Detector Computed Tomography Fistulography In Patients of Fistula-in-Ano: An Imaging Collage |
title_full_unstemmed | Multi Detector Computed Tomography Fistulography In Patients of Fistula-in-Ano: An Imaging Collage |
title_short | Multi Detector Computed Tomography Fistulography In Patients of Fistula-in-Ano: An Imaging Collage |
title_sort | multi detector computed tomography fistulography in patients of fistula-in-ano: an imaging collage |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5894016/ https://www.ncbi.nlm.nih.gov/pubmed/29662582 http://dx.doi.org/10.12659/PJR.901523 |
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