Magnetic resonance imaging with dynamic contrastenhancement in perianal fistula staging

Magnetic resonance imaging with dynamic contrastenhancement in perianal fistula staging

Aim: To investigate whether dynamic contrast enhanced perfusion T1-weighted (DCE T1-W) three-dimensional volume interpolatedbreath-hold examination (3-D vibe) contributes to perianal fistula staging. Materials and Methods: A total of 110 patients who underwent pelvic magnetic resonance imaging (MRI) (1,5 tesla, Siemens, Avanto)with the preliminary diagnosis of perianal fistula were included in our retrospective study. In our perianal fistula MRI protocol, DCET1-W 3D vibe sequence was in axial plane with fat-saturation and in five phases (precontrast phase and then in the $45^{th}$, $60^{th}$, $180^{th}$ and $240^{th}$ seconds after intravenous contrast administration). Perianal fistula staging was performed according to T2-weightedsequence findings (acute, subacute, chronic) and by clinical history. Semi-quantitative measurements of the perianal fistula weremade with the ROIs placed on the perianal fistula and left femoral artery. Then measurements were made as follows: Type ofcontrast curve obtained, staining peak time and slope angle of the curve. All measurements were performed independently by tworadiologists at different times. Interobserver agreement was also evaluated (Cohen’s kappa). Results: The phases of reaching the peak time (TTP) of contrast increases as the perianal fistula stage increases (mean phases ofTTP values were$2.2^{th}$± 1.2 in acute phase fistulas, $2.8^{th}$ ± 1.2 in subacute perianal fistulas; $4.4^{th}$ ± 1 in chronic fistulas). The angleof inclination decreased as the stage of the perianal fistula increased (42.2 ± 13.2 degrees; 27 ± 11.3 degrees and 9.6 ± 2.3 degrees,respectively). Conclusion: Diagnosis of perianal fistula with physical examination can be confusing. Sometimes there can be fistulas with differentstages in the same patient. Therefore, the use of IV contrast-enhanced pelvic examination with dynamic technique may provideinformation about the perianal fistula stage.

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  • 1. Criado JDM, García L, Fraga P, et al. MR Imaging Evaluation of Perianal Fistulas : Spectrum of Imaging. RadioGraphics 2012;32:175-94
  • 2. Daabis N, Shafey R El. Magnetic resonance imaging evaluation of perianal fistula. Egypt J Radiol Nucl Med 2013;44:705-11.
  • 3. Gaa T, Neumann W, Sudarski S, et al. Comparison of perfusion models for quantitative T1 weighted DCEMRI of rectal cancer. Scientific Reports 2017;7:12036
  • 4. Hameeduddin A, Sahdev A. Diffusion-weighted imaging and dynamic contrast-enhanced MRI in assessing response and recurrent disease in gynaecological malignancies. Hameeduddin and Sahdev Cancer Imaging 2015;15:3
  • 5. Gilbert ÃG, Nguyen ÃBN, Tang A. Liver Fibrosis Quantification by Magnetic Resonance Imaging. Top Magn Reson Imaging 2017;26:229-41.
  • 6. Heye T, Davenport MS, Horvath JJ, et al. Reproducibility of Dynamic Part I . Perfusion Characteristics in the Female Pelvis by Using Multiple Computer-aided Diagnosis Perfusion Analysis Solutions. Radiology 2013;266:801-11.
  • 7. Keller S, Aigner A, Zenouzi R, et al. Association of gadolinium-enhanced magnetic resonance imaging with hepatic fibrosis and inflammation in primary sclerosing cholangitis. PLoS ONE 2018;13: e0193929
  • 8. Tofts PS. T1 -weighted DCE Imaging Concepts: Modelling, Acquisition and Analysis. Magnetom Flash 2010;1-5
  • 9. Ippolito D, Lombardi S, Franzesi CT, et al. Dynamic Contrast-Enhanced MR with Quantitative Perfusion Analysis of Small Bowel in Vascular Assessment between Inflammatory and Fibrotic Lesions in Crohnʼ s Disease : A Feasibility Study. Hindawi Contrast Media & Molecular Imaging Volume 2019, Article ID 1767620
  • 10. Mazaheri Y, Akin O, Hricak H. Dynamic contrastenhanced magnetic resonance imaging of prostate cancer: A review of current methods and applications. World J Radiol 2017;9:416-25.
  • 11. Gordon Y, Partovi S, Müller-eschner M, et al. Dynamic contrast-enhanced magnetic resonance imaging : fundamentals and application to the evaluation of the peripheral perfusion. Cardiovasc Diagn Ther 2014;4:147-64.
  • 12. Sahnan K, Adegbola SO, Tozer PJ, et al. Innovation in the imaging perianal fistula: a step towards personalised medicine. Therap Adv Gastroenterol. 2018; 11:1756284818775060
  • 13. Zand KR,Reinhold C,Haider MA, Nakai A, et al; Artifacts and Pitfalls in MR Imaging of the Pelvis;J. Magn. Reson. Imaging 2007;26:480-97.
  • 14. Krupa K,Bekiesińska-Figatowska M; Artifacts in Magnetic Resonance Imaging;Pol J Radiol 2015;80: 93-106.
Annals of Medical Research-Cover
  • Yayın Aralığı: 12
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
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