1Senior Resident, Department of Radiology, Sharda School of Medical Sciences & Research, Sharda University, Greater Noida, U.P, India.
2Professor & Head, Department of Radiology, Sharda School of Medical Sciences & Research, Sharda University, Greater Noida, U.P, India.
3*Associate Professor, Department of Radiology, Sharda School of Medical Sciences & Research, Sharda University, Greater Noida, U.P, India.
4Senior Resident, Department of Radiology, Sharda School of Medical Sciences & Research, Sharda University, Greater Noida, U.P, India.
5Post Graduate Resident, Department of Radiology, Sharda School of Medical Sciences & Research, Sharda University, Greater Noida, U.P, India.
6Post Graduate Resident, Department of Radiology, Sharda School of Medical Sciences & Research, Sharda University, Greater Noida, U.P, India.
Anorectal fistula is a common yet complex condition of the anorectal region, often resulting from cryptoglandular infections. It typically presents as a persistent or recurrent discharging sinus and can significantly impair the patient's quality of life due to chronic pain, discomfort, and social embarrassment. The intricate anatomy of the anal sphincter complex, combined with the potential for multiple internal and external openings, secondary tracts, and deep-seated abscesses, makes accurate diagnosis and management particularly challenging. Surgical intervention remains the definitive treatment; however, the risk of recurrence and fecal incontinence underscores the need for precise preoperative evaluation. Magnetic Resonance Imaging (MRI) has emerged as the gold standard for imaging anorectal fistulas, offering unparalleled soft tissue contrast, multiplanar capabilities, and detailed visualization of fistulous anatomy. MRI fistulography enables accurate delineation of the primary fistulous tract, identification of internal and external openings, detection of secondary ramifications, and assessment of associated inflammatory changes—all critical factors influencing surgical planning and outcomes. In this prospective, cross-sectional study, 33 adult patients with clinically diagnosed fistula-in-ano were evaluated using MRI at Sharda Hospital, Greater Noida, over an 18-month period. MRI was performed using a 3 Tesla scanner with standard T1-weighted, T2-weighted, and fat-suppressed SPAIR sequences in axial, coronal, and sagittal planes. MRI findings were categorized based on the Parks anatomical classification and the St. James University Hospital MRI grading system and in identifying fistula type, internal and external openings, secondary tracts, and associated abscesses with systematically correlating with intraoperative surgical findings. The study revealed a male predominance (78.8%) and a peak incidence in the 26–40 age group (51.5%). Discharge was the most common presenting symptom (72.7%), followed by pain and swelling. The most frequent fistula type was intersphincteric (72.7%), with the 6 o'clock position being the most common site for internal openings (39.4%). MRI findings showed a strong correlation with surgical observations (Pearson correlation coefficient = 0.897, p < 0.001), confirming its reliability in preoperative assessment. St. James's University Hospital Classification identified Grade I as the most prevalent fistula type (57.5%). In conclusion, MRI fistulography is a highly accurate imaging modality for evaluating perianal fistulas. It provides critical preoperative insights into the anatomical course of the fistulous tract, its relationship with sphincter muscles, and secondary complications, thus improving surgical planning and patient outcomes.
Keywords: MRI Fistulography, Ano-Rectal Fistula, Surgical Correlation, Park's Classification, St. James Classification.
How to cite this article: Gupta A, Gupta V, Bhagat S, Sahni A, Tushir M, Jain V. Role Of MRI Fistulography In Ano-Rectal Fistula And Its Correlation With Surgical Findings. Int J Drug Deliv Technol. 2026;16(15s): 402-406. DOI: 10.25258/ijddt.16.15s.48
Source of support: Nil.
Conflict of interest: None