Diagnostic accuracy of magnetic resonance imaging in diagnosing and classifying fistula in ANO taking surgical findings as gold standard.

Objective: The gold standard for assessing the diagnostic precision of magnetic resonance imaging in identifying an ano fistula is surgical findings. Study Design: Comparative Cross-sectional study. Setting: Department of Radiology, Aziz Fatima Medical and Dental College, Affiliated Hospital, and Allied Hospital Faisalabad. Period: November 2024 to March 2025. Methods: Eighty patients, of either gender, aged 25–70 years, with suspected fistual symptoms lasting more than four weeks, were included. The following patients were not included: those with a history of perianal fistula surgery and those who were contraindicated for MR imaging due to cardiac. They were evaluated with pelvic magnetic resonance imaging (1.5T) utilizing a phase array coil without intestinal preparation. Patients were placed in a supine position for the purpose of acquiring images. To ascertain the presence and grade of the fistula, the consultant radiologist assessed the MRI findings. The MRI results and the surgical results were compared after surgery was performed in the relevant ward. Results: Overall MRI sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy are used to determine the ano fistula using surgical findings as the gold standard were 90.80%, 90.0%, 91.62%, 89.06%, and 90.44%, respectively. Conclusion: According to the study's findings, magnetic resonance imaging has a fairly high diagnostic accuracy when used to evaluate perianal fistulas prior to surgery.