title: Direct MRI fistulography with hydrogen peroxide in patients with recurrent perianal fistulas: a new proposal of extended diagnostics.
abstract: BACKGROUND
  Perianal fistulas are malformations of the anorectal area. Accurate preoperative assessment of perianal fistula tract is a main assumption in diagnosis of the disease, affecting the operation efficiency. The aim of the study was to present our experience in application of a new diagnostic protocol based on the magnetic resonance imaging (MRI) examination using a mixture of hydrogen peroxide (HP) and gadolinium as a direct contrast medium in evaluation of recurrent fistulas tract. The method is referred to as HPMRI.
  
  
  METHODS
  The study group consisted of 12 subjects operated on from 2011. Direct HPMRI fistulography was performed in all subjects before the operation. All types of fistulas were precisely evaluated by HPMRI examination.
  
  
  RESULTS
  Intraoperative state confirmed complete course of fistulas in 11 cases. In 1 case, an internal opening was not found.
  
  
  CONCLUSIONS
  We suggest that this new method of direct HPMRI fistulography may improve visualization of the tracts of recurrent fistulas and improve efficacy of surgical procedures.
authors: Department of Surgery Propedeutics, Clinical Department of General, Colorectal and Trauma Surgery, Medical University of Silesia, Sosnowiec, Poland.
authors: Dariusz
authors: D
authors: Waniczek
authors: Magnetic Resonance Unit, Medical Diagnostic Centre Voxel, Bytom, Poland.
authors: Tomasz
authors: T
authors: Adamczyk
authors: Department of Surgery Propedeutics, Clinical Department of General, Colorectal and Trauma Surgery, Medical University of Silesia, Bytom, Poland.
authors: Jerzy
authors: J
authors: Arendt
authors: Department and Institute of Medical Radiology and Radiodiagnostics, Medical University of Silesia, Zabrze, Poland.
authors: Ewa
authors: E
authors: Kluczewska
mesh_terms: D000328:Adult; D005260:Female; D005682:Gadolinium; D006801:Humans; D006861:Hydrogen Peroxide; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012003:Rectal Fistula / Q000175:diagnosis* / Q000473:pathology*; D012008:Recurrence
chemical_list: D005682:Gadolinium; D006861:Hydrogen Peroxide