title: The comparison of CT fistulography and MR imaging of perianal fistulae with surgical findings: a case-control study.
abstract: The purpose of this study was to evaluate the diagnostic efficacies of CT fistulography and MRI, in the diagnostic work-up of perianal fistula patients.
  
  
  
  All 41 patients who were included in the study (36 males and 5 females, with an average age of 41 years) underwent CT fistulography and MRI examinations prior to surgery. The fistula characteristics obtained from these examinations were compared with the surgical findings. The comparative results were evaluated by means of the Kappa analysis method.
  
  
  
  CT fistulography predicted the correct perianal fistula classification in 30 (73.1%) of the 41 patients, whereas MRI correctly defined fistula classification in 38 (92.7%) of these patients (the K values were 0.621 and 0.896, respectively; with p < 0.001). CT fistulography depicted 29 secondary extensions in 16 patients, whereas MR imaging revealed 28 secondary extensions in 15 patients. A substantial agreement was found between surgical findings and two modalities (K value was 0.789 and 0.793 for CT fistulography and MRI, respectively, with a p value < 0.001). In terms of locations of internal openings, CT fistulography was able to detect the locations in 28 patients (68.2%), whereas MRI was more successful in this aspect, with a number of 35 patients (85.3%). Granulation tissues, inflammation and edema around the fistula, abscesses, and fistular wall fibrosis were also evaluated.
  
  
  
  CT fistulography and MRI have different advantages in the diagnosis of perianal fistulas. A good command of knowledge concerning the issue may be a key factor in modality decision.
authors.affiliation: Department of Radiology, Numune Teaching and Research Hospital, Ege bagatur Bulvari Serinevler Yüreğir, Adana, Turkey. gsoker@hotmail.com.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Soker
authors.affiliation: Department of Radiology, Numune Teaching and Research Hospital, Ege bagatur Bulvari Serinevler Yüreğir, Adana, Turkey.
authors.forename: Bozkurt
authors.initials: B
authors.lastname: Gulek
authors.affiliation: Department of Radiology, Numune Teaching and Research Hospital, Ege bagatur Bulvari Serinevler Yüreğir, Adana, Turkey.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Yilmaz
authors.affiliation: Department of Radiology, Numune Teaching and Research Hospital, Ege bagatur Bulvari Serinevler Yüreğir, Adana, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Kaya
authors.affiliation: Department of Radiology, Numune Teaching and Research Hospital, Ege bagatur Bulvari Serinevler Yüreğir, Adana, Turkey.
authors.forename: Muhammet
authors.initials: M
authors.lastname: Arslan
authors.affiliation: Department of Radiology, Numune Teaching and Research Hospital, Ege bagatur Bulvari Serinevler Yüreğir, Adana, Turkey.
authors.forename: Okan
authors.initials: O
authors.lastname: Dilek
authors.affiliation: Department of General Surgery, Numune Teaching and Research Hospital, Adana, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Gorur
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Cukurova University, Adana, Turkey.
authors.forename: Ferit
authors.initials: F
authors.lastname: Kuscu
authors.affiliation: Department of General Surgery, Numune Teaching and Research Hospital, Adana, Turkey.
authors.forename: Oktay
authors.initials: O
authors.lastname: İrkorucu
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000000981:diagnostic imaging / Q000601:surgery; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010502:Perineum / Q000000981:diagnostic imaging / Q000601:surgery; D011446:Prospective Studies; D012003:Rectal Fistula / Q000000981:diagnostic imaging* / Q000601:surgery*; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: CT fistulography; MR imaging; Perianal fistulae