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There are a range of sphincter-preserving procedures available to treat anorectal fistula, some of which can be precluded, or rendered more optimal by specific features of fistula anatomy. Magnetic resonance imaging (MRI) is the gold standard modality for assessing anorectal fistula. To maximise clinical utility, the MRI report should accurately describe these clinically relevant features. We aimed to develop a minimum dataset for reporting MRI of anorectal fistula, in order to improve the assessment and management of these patients. A longlist of 70 potential items for the minimum dataset was generated through systematic review of the literature. This longlist was presented to radiologists, surgeons and gastroenterologists in an online survey to understand the features that shape current clinical practice. The longlist and survey results were then presented to an expert consensus panel to generate the final minimum dataset through discussion and anonymous voting. The final minimum dataset details the general characteristics, features of the internal and external openings, path of the fistula through the sphincters and any associated extensions and collections that should be described in all MRI reports for anal fistula. Additional surgical and perianal Crohn's disease subsets were developed to indicate the features that aid decision-making for these patients, in addition to a minimum dataset for the clinical request. This study represents a multi-disciplinary approach to developing a minimum dataset for MRI reporting of anal fistula, highlighting the most important features to report that can assist in clinical decision-making. KEY POINTS: • This paper recommends the minimum features that should be included in all MRI reports for the assessment of anal fistula, including Parks classification, number of tracts, features of the internal and external opening, path of the tract through the sphincters, the presence and features of extensions and collections. • Additional features that aid decision-making for surgery or in the presence of Crohn's disease have been identified. • The items that should be included when requesting an MRI are specified.

有一系列可用于治疗肛门直肠瘘的保留括约肌手术，其中一些可以通过瘘管解剖的特定特征来排除或使其更优化。磁共振成像（MRI）是评估肛门直肠瘘的金标准方式。为了最大限度地提高临床实用性，MRI 报告应准确描述这些具有临床意义的特征。我们旨在开发一个肛门直肠瘘 MRI 报告的最小数据集，以改善这些患者的评估和管理。通过对文献的系统回顾，生成了一个包含 70 个潜在项目的最小数据集长清单。这个长清单通过在线调查呈现给放射科医生、外科医生和胃肠病学家，以了解塑造当前临床实践的特征。长清单和调查结果随后提交给专家共识小组，通过讨论和匿名投票生成最终的最小数据集。最终的最小数据集详细说明了一般特征、内口和外口的特征、瘘管通过括约肌的路径以及所有 MRI 报告中都应描述的任何相关延伸和集合。还开发了额外的外科和肛周克罗恩病亚组，以指示这些患者决策辅助的特征，除了临床请求的最小数据集外。这项研究代表了一种多学科方法，用于开发肛门直肠瘘 MRI 报告的最小数据集，突出了报告有助于临床决策的最重要特征。要点：