title: Prospective Comparison of Magnetic Resonance Imaging, Transrectal and Transperineal Sonography, and Surgical Findings in Complicated Perianal Crohn Disease.
abstract: OBJECTIVE
  Magnetic resonance imaging (MRI) and transrectal sonography are the two accepted imaging modalities for evaluation of perianal fistulas and abscesses. Transperineal sonography is a new technique that is easy to learn and can be performed at any time. The purpose of this study was to prospectively compare the diagnostic accuracy of MRI, transrectal sonography, and transperineal sonography with surgical findings in patients with perianal Crohn disease.
  
  
  METHODS
  All patients with perianal Crohn disease underwent MRI, transrectal sonography, and transperineal sonography within a few days before surgery. Fistulas were classified as simple (43.8%) or complex (52.2%) based on surgical findings.
  
  
  RESULTS
  Twenty-three patients with active perianal Crohn disease (12 women and 11 men; mean age, 29.9 years; current therapy: antibiotics, 69.6%; azathioprine, 56.5%; and biologics, 73.9%; previous surgery, 26.1%; and proportion of smokers, 39.1%) were included. Sensitivity values for MRI, transrectal sonography, and transperineal sonography for diagnosis of fistulas were 84.6%, 84.6%, and 100%, respectively. Transperineal sonography was more sensitive for diagnosis of perianal abscesses than MRI and transrectal sonography (100%, 58.8%, and 92.8%).
  
  
  CONCLUSIONS
  Transperineal sonography is a very accurate diagnostic method with outstanding sensitivity compared with MRI and transrectal sonography for evaluation of complicated perianal Crohn disease. Due to its simplicity and low cost, it is recommended that transperineal sonography be the first diagnostic modality in these cases.
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Renáta
authors.initials: R
authors.lastname: Bor
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Klaudia
authors.initials: K
authors.lastname: Farkas
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Anita
authors.initials: A
authors.lastname: Bálint
authors.affiliation: Departments of Medical Physics and Informatics, University of Szeged, Szeged, Hungary.
authors.forename: Mónika
authors.initials: M
authors.lastname: Szűcs
authors.affiliation: Department of Surgery, University of Szeged, Szeged, Hungary.
authors.forename: Szabolcs
authors.initials: S
authors.lastname: Ábrahám
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Ágnes
authors.initials: Á
authors.lastname: Milassin
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Mariann
authors.initials: M
authors.lastname: Rutka
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Nagy
authors.affiliation: Department of Radiology, University of Szeged, Szeged, Hungary.
authors.forename: Péter
authors.initials: P
authors.lastname: Milassin
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szepes
authors.affiliation: First Department of Medicine, University of Szeged, Szeged, Hungary molnar.tamas@med.u-szeged.hu.
authors.forename: Tamás
authors.initials: T
authors.lastname: Molnár
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002648:Child; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000601:surgery*; D019160:Endosonography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010481:Perianal Glands / Q000000981:diagnostic imaging / Q000601:surgery; D010502:Perineum / Q000000981:diagnostic imaging* / Q000601:surgery; D011446:Prospective Studies; D012007:Rectum / Q000000981:diagnostic imaging* / Q000601:surgery; D015203:Reproducibility of Results; D014463:Ultrasonography; D055815:Young Adult
keywords: gastrointestinal ultrasound; perianal Crohn disease; perianal fistula; transperineal sonography; transrectal sonography