ArticleLa Radiologia medica2019
Preoperative assessment of simple and complex anorectal fistulas: Tridimensional endoanal ultrasound? Magnetic resonance? Both?
Article in La Radiologia medica, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease.Annals of coloproctology · 2024Guideline
- Diagnostic Accuracy of Three-Dimensional Endoanal Ultrasound for Anal Fistula: A Systematic Review and Meta-analysis.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2021Pooled it
- A predictive model for differentiating perianal Crohn's disease activity with 3D transrectal ultrasonography.European radiology · 2026Article
- Preoperative transrectal three-dimensional ultrasound improves complex anal fistula diagnosis and surgical outcomes.The Journal of international medical research · 2026Article
- Artificial intelligence-assisted detection of internal openings in anal fistulas using endorectal ultrasound: a YOLOv11-based diagnostic system.Translational gastroenterology and hepatology · 2026Article
- Imaging in perianal fistulising Crohn's disease: A practical guide for the gastroenterologist.World journal of gastroenterology · 2025Review
- Magnetic resonance imaging for suspected perianal Crohn's disease in children: a multi-reader agreement study.European radiology · 2025Article
- Validation of a novel imaging-guided and anatomy-based classification system for anorectal fistulas: a retrospective clinical evaluation study.Annals of coloproctology · 2025Article
- Iatrogenic Proximal Urethro-Rectal Perforation During Foley Catheter Insertion.Case reports in surgery · 2025Article
- Structured magnetic resonance imaging and endoanal ultrasound anal fistulas reporting template (SMART): An interdisciplinary Delphi consensus.World journal of gastrointestinal surgery · 2024Article
- Preoperative Assessment of Perianal Fistulas with Combined Magnetic Resonance and Tridimensional Endoanal Ultrasound: A Prospective Study.Diagnostics (Basel, Switzerland) · 2023Article
- Sacral nerve modulation for patients with fecal incontinence: long-term outcome and effects on sexual function.Updates in surgery · 2023Article
- Comparison of contrast-enhanced fat-suppressed T1-3D-VIBE and T1-TSE MRI in evaluating anal fistula.Abdominal radiology (New York) · 2022Article
- Benign Anorectal Disorder Management in Low-Resource Settings.Clinics in colon and rectal surgery · 2022Review
- Guidelines to diagnose and treat peri-levator high-5 anal fistulas: Supralevator, suprasphincteric, extrasphincteric, high outersphincteric, and high intrarectal fistulas.World journal of gastroenterology · 2022Review
- Dynamic contrast-enhanced (DCE) imaging: state of the art and applications in whole-body imaging.Japanese journal of radiology · 2022Review
- Treating highly complex anal fistula with a new method of combined intraoperative endoanal ultrasonography (IOEAUS) and transanal opening of intersphincteric space (TROPIS).Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2021Article
- Safety and effectiveness of minimal sphincterotomy in the treatment of female patients with chronic anal fissure.Updates in surgery · 2021Article
- Large Bowel Ischemia/Infarction: How to Recognize It and Make Differential Diagnosis? A Review.Diagnostics (Basel, Switzerland) · 2021Review
- Deep Learning-Based CT Image Characteristics and Postoperative Anal Function Restoration for Patients with Complex Anal Fistula.Journal of healthcare engineering · 2021Article
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of the study is to evaluate the diagnostic value of tridimensional endoanal ultrasound (3D-EAUS) and magnetic resonance (MR) in the preoperative assessment of both simple and complex anorectal fistulas.
methodsAll the patients referred for the treatment of anal fistulas were enrolled in this study and underwent, as preoperative assessment, anamnestic evaluation, clinical examination, and unenhanced and H2O2-enhanced 3D-EAUS and MR. The results of imaging evaluation were compared with surgical findings, considered as reference standard.
resultsDuring the study period, 124 patients operated on for anal fistulas underwent complete preoperative imaging assessment. Perfect agreement between 3D-EAUS and surgery in the anal fistulas' severity grading was found (K = 1). The fistulas were classified as simple in 68/126 (53.9%) and complex in 58/126 (46.03%) cases, according to fistulas' Parks' classification and the most recent American Guidelines. In both simple and complex anal fistulas, 3D-EAUS did not show a significantly higher accuracy in the evaluation of internal openings, if compared with MR (P = 0.47; McNemar's Chi-square test). In the complex anal fistulas, MR showed a significantly higher accuracy in the evaluation of secondary extensions if compared with 3D-EAUS (P = 0.041; McNemar's Chi-square test), whereas in the simple anal fistulas, no significant difference was found.
conclusionIn the preoperative work-up of patients with anorectal fistulas, 3D-EAUS may represent the first-line diagnostic tool. In cases of fistulas classified as complex by 3D-EAUS, MR may be indicated as adjunctive diagnostic imaging examination, to more carefully describe the fistulas' complete anatomy.
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