COMPARATIVE STUDY OF MRI FISTULOGRAM WITH INTRAOPERATIVE FINDINGS IN FISTULA IN ANO

Background: MRI is an important imaging modality which gives description of the stula within the anal canal in relation to the sphincter complex, other pelvic oor structures and presence of an abscess. Because of high soft tissue contrast, MRI was chosen as the imaging of choice for preoperative diagnosis and classication of perianal stulas. The study's main aim was to evaluate the role of MR FISTULOGRAM in preoperative assessment of anorectal stulas and to correlate MR ndings with intra operative ndings. Methods: This study was a hospital based prospective and descriptive study conducted from June, 2023 to July, 2024 at Department of Surgery, S.P. Medical College and P.B.M. hospital, Bikaner. 60 patients who underwent surgery and had preoperative MRI were included in this study. Results: The sensitivity and specicity of MRI for St James grade I and II stulas were 100%, 91% and 73%, 100% respectively. For grade III, IV and V the sensitivity and specicity were 100%. The most prevalent type of stula was intersphincteric type in 32 patients. Commonest age group was 31 to 40 years and commonly seen in males. The operative ndings were well correlating with the MRI ndings with regard to the site of the openings. Identication of secondary tracts is essential for complete eradication of the disease. Conclusion: MRI is key to demonstrate the relationship of sphincters with the stulous tracks and for determination of secondary complications. MRI offer ner anatomic details of stulae and also identies secondary tracks and abscesses. Our study has concluded that MRI with contrast study is crucial for management, identify active inammation of tracks and differentiate between scar and granulation tissue. Correct recognition of perianal stulae and proper grading are necessary for ensuring best surgical result.