Background: Anal fistula is one of the most frequently reported anorectal disorders that has a propensity to recur, particularly in complex cases usually because of un-detected sepsis at operation time.
The aim of our review was to assess the diagnostic validity of pelvic MRI with MR Fistulogram in the diagnosis, assessment and classification of Peri-anal fistula.
Main text: A broad literature review has been done, searching the electronic databases including Google Scholar and PubMed using keywords like perianal fistula, MRI, and anorectal sepsis, in addition to the standard text-books of colorectal diseases.
Contrast X-rays, CT scans, anal endo-sonography, and MRI are the methods utilized for pre-operative scanning of fistula in ano(1). Because of its low accuracy, X-ray fistulo-graphy seldomly utilized for imaging of peri-anal fistula(2). CT fistula-graphy may be more precise in patients presented with acute inflammation, abscess or the fistulae connected with inflammatory bowel diseases(3).
Anal endo-sonography and MR-imaging are commonly utilized and dependable imaging methods for fistula in ano(2). The usage of 3D technologies has upgraded the precision of anal endo-sonography. MR-Imaging is now considered the favorite option(4). But, several researches have showed similar accuracies for both MR-Imaging and anal endo-sonography with similar sensitivity. However, with more MRI specificity(5).
Conclusion: MRI is extremely effective in preoperative classification of Peri-anal fistulae, thus enabling selection of correct surgical procedure and preventing recurrence.