Volume : 7, Issue : 8, August - 2018

ROLE OF TRANSPERINEAL ULTRASONOGRAPHY IN EVALUATION OF PERIANAL FISTULA AND ITS CORRELATION WITH MAGNETIC RESONANCE IMAGING

Dr. Rakesh Vijayvargiya, Dr. Archana Bhatnagar, Dr. Amaresh Kumar Shukla, Dr. Sanjay Tekam

Abstract :

<p class="MsoNoSpacing" style="text-align:justify;text-justify:inter-ideograph;&#10;line-height:200%"><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="font-size:14.0pt;line-height:200%">Aim:</span></b><span lang="EN-IN" style="font-size:14.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;color:black;letter-spacing:-.15pt;mso-no-proof:yes">The&nbsp;aim of the present study is to conclude the sensitvity &amp; specificity between MRI and transcutaneous ultrasonograpy in detection of perianal fistulas andaccurate assessment of disease status of perianal fistulous tract and extent in relation to sphincteric complex and help in surgical planning to minimize recurrence.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;text-justify:inter-ideograph;line-height:200%"><b style="mso-bidi-font-weight:&#10;normal"><span style="font-size:14.0pt;line-height:200%">Methods:</span></b><span style="font-size:14.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-fareast-font-family:&quot;Book Antiqua&quot;">This prospective study was done in the Department of Radiodiagnosis&amp; Krssna diagnostic centre at Mahatma Gandhi Memorial Medical College &amp; M.Y. Hospital,Indore, Madhya Pradesh, Indiafrom March 2016 to August 2017. A total of 50 patients who were </span><span style="font-size:14.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-fareast-font-family:Calii;mso-bidi-font-weight:bold">present with a clinical suspicious </span><span style="font-size:14.0pt;line-height:200%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&quot;Book Antiqua&quot;;&#10;mso-bidi-font-weight:bold">of </span><span style="font-size:14.0pt;line-height:&#10;200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:Calii;&#10;mso-bidi-font-weight:bold">perianal fistula and visible external opening in anal region, they</span><span style="font-size:14.0pt;line-height:200%;&#10;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&quot;Book Antiqua&quot;">were evaluated by Transperianal ultrasonography (TPUS) and MRI fistulogram and result were ensured by surgical results.<span style="color:#292526"><o:p></o:p></span></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph;&#10;line-height:200%"><b style="mso-bidi-font-weight:normal"><span style="font-size:14.0pt;line-height:200%">Results:</span></b><span style="font-size:14.0pt;mso-bidi-font-size:11.0pt;line-height:200%;font-family:&#10;&quot;Times New Roman&quot;,&quot;serif&quot;">The accuracy of TPUS and MRI in detection of perianal abscess, the sensitivity, specificity, PPV and NPV of USG was found to be 92%, 100%, 100% and 91% respectively, while the sensitivity, specificity, PPV and NPV of MRI was found to be 100%, 90%, 93% and 100% respectively. The combination of MRI and TPUS is capable of detecting perianal fistulas with sensitivity of 100%. Abscesses were detected by TPUS with the same sensitivity as by MRI. TPUS therefore is a valuable tool in the screening for perianal disease. <o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;text-justify:inter-ideograph;line-height:200%"><b style="mso-bidi-font-weight:&#10;normal"><span style="font-size:14.0pt;line-height:200%">Conclusion:</span></b><span style="font-size:14.0pt;line-height:200%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">The combination of MRI and TPUS is capable of detecting perianal fistulas with sensitivity of 100%. Abscesses were detected by TPUS with the same sensitivity as by MRI. Thus,&nbsp;the&nbsp;sensitivity&nbsp;and specificity of TPUS was comparable to MRI for detection of perianal fistula and abscess.<o:p></o:p></span></p>