Aggarwal Rohit, Soni Brijesh K, Kumar Joish U, George Raju A, Sivasankar Rajeev
Department of Radiodiagnosis, Command Hospital Air Force, Bengaluru, Karnataka, India.
Department of Radiodiagnosis, Indian Naval Hospital Ship, Mumbai, India.
Indian J Radiol Imaging. 2017 Apr-Jun;27(2):161-166. doi: 10.4103/ijri.IJRI_373_16.
Perianal fistula is a commonly encountered condition in routine surgical practice. Accurate presurgical mapping of these tracts is vital to prevent recurrence. We have assessed the effectiveness of percutaneous instillation of aqueous jelly prior to magnetic resonance (MR) fistulography.
To study the role of percutaneous instillation of aqueous jelly in fistulous tracts prior to MR fistulography.
All patients with active discharge, referred for MR fistulography between January 2014 and April 2016, were included in this study. Approximately 3-5 ml of sterile aqueous jelly was percutaneously instilled into the external openings prior to MR fistulography. Post MR fistulography, patients were monitored till surgery for pain, fever, or bleeding. The type of fistulae, location of internal openings, lateral ramifications, and presence of abscess were compared with per operative findings for diagnostic accuracy.
Sixty-four patients enrolled in our study had undergone preoperative MR fistulography with aqueous jelly instillation. MR fistulography revealed a total of 77 tracts and showed a sensitivity and specificity of 100% in delineation of type of tract. Forty-nine internal openings were identified with 94.2% sensitivity, 100% specificity, and 95.3% accuracy. 90.5% sensitivity, 100% specificity, and accuracy of 97% were observed in delineation of lateral ramifications. None of the patients reported pain, fever, or bleeding post procedure till surgery.
Percutaneous instillation of aqueous jelly prior to MR fistulography is a safe, cost effective, and accurate technique to provide a comprehensive delineation of the complex anatomy of perianal fistulae.
肛周瘘是常规外科手术中常见的病症。这些瘘管术前的精确造影对于预防复发至关重要。我们评估了在磁共振（MR）瘘管造影之前经皮注入水性凝胶的有效性。
研究在MR瘘管造影之前经皮向瘘管注入水性凝胶的作用。
纳入2014年1月至2016年4月期间因MR瘘管造影而转诊的所有有活动性分泌物的患者。在MR瘘管造影之前，经皮向外部开口注入约3 - 5毫升无菌水性凝胶。MR瘘管造影后，对患者进行监测直至手术，观察是否有疼痛、发热或出血。将瘘管类型、内口位置、侧支分支情况及脓肿的存在与否与手术中的发现进行比较，以评估诊断准确性。
我们研究中的64例患者接受了术前经水性凝胶注入的MR瘘管造影。MR瘘管造影共显示77条瘘管，在瘘管类型的描绘上敏感性和特异性均为100%。确定了49个内口，敏感性为94.2%，特异性为100%，准确性为95.3%。在侧支分支的描绘中，敏感性为90.5%，特异性为100%，准确性为97%。直到手术，没有患者报告术后疼痛、发热或出血。
在MR瘘管造影之前经皮注入水性凝胶是一种安全、经济有效且准确的技术，可全面描绘肛周瘘的复杂解剖结构。
