Garg Pankaj, Kaur Baljit, Yagnik Vipul D, Dawka Sushil
Department of Colorectal Surgery, Garg Fistula Research Institute, Panchkula 134113, Haryana, India.
Department of Radiology, SSRD Magnetic Resonance Imaging Institute, Chandigarh 160011, Chandigarh, India.
World J Gastrointest Surg. 2022 Apr 27;14(4):271-275. doi: 10.4240/wjgs.v14.i4.271.
The main purpose of a radiologist's expertise in evaluation of anal fistula magnetic resonance imaging (MRI) is to benefit patients by decreasing the incontinence rate and increasing the healing rate. Any loss of vital information during the transfer of this data from the radiologist to the operating surgeon is unwarranted and is best prevented. In this regard, two methods are suggested. First, a short video to be attached with the standardized written report highlighting the vital parameters of the fistula. This would ensure minimum loss of information when it is conveyed from the radiologist to the operating surgeon. Second, inclusion of a new parameter, the amount of external sphincter involvement by the anal fistula. This parameter is usually not included in the MRI report. This can be evaluated as the height of penetration of the external anal sphincter (HOPE) by the fistula. The external anal sphincter plays a pivotal role in maintaining continence. This parameter (HOPE) is distinct from the 'height of internal opening' and assumes immense importance as its knowledge is paramount to prevent damage to the external anal sphincter by the surgeon during surgery.
放射科医生在评估肛瘘磁共振成像（MRI）方面的专业技能的主要目的是通过降低失禁率和提高治愈率使患者受益。在将这些数据从放射科医生传递给外科手术医生的过程中，任何重要信息的丢失都是不必要的，最好加以避免。在这方面，建议采用两种方法。第一，在标准化书面报告中附上一个短视频，突出瘘管的关键参数。这将确保在从放射科医生传达给外科手术医生时信息损失最小。第二，纳入一个新参数，即肛瘘对外括约肌的累及程度。该参数通常不包含在MRI报告中。这可以通过瘘管对外括约肌的穿透高度（HOPE）来评估。肛门外括约肌在维持控便方面起着关键作用。这个参数（HOPE）与“内口高度”不同，并且由于其对于防止外科医生在手术过程中损伤肛门外括约肌至关重要，因而具有极其重要的意义。
