Objective: To asses role of MRI in perianal fissure and fistula and to evaluate complications. Materials and Methods: Total 50 patients, who were clinically diagnosed as suffering from perianal fissure/fistula, were recruited. Each patient was studied in detail with relevant clinical history and Examination. MRI was performed on 1.5 T Philips scanner with patient in prone position using body coil, no special bowel preparation was used. Results: A total of 50 cases of perianal fissure/fistula, most patients were in age group of 31 to 50 years, 43 patients were males (86%) & 7 patients were females (14%). 3 cases (6%) had previous operative history for perianal fistula and shows recurrence. 36(72%) tracts were trans-sphincteric type followed by inter-sphincteric type (13, 26%) & 1 (2%) fistula was of supra-sphincteric type. grade IV fistulas were found in 19 cases (38%), grade III fistulas found in 17 cases (34%), grade I & grade II fistulas were found in 7 cases (14%) & 6 cases (12%) respectively & grade V fistulas in 1 patient (2%). 41 patients had single external opening while 7 patient had multiple external openings. One patient had sub mucosal fissure and one patient had only internal opening(sinus) disease. 44 patients had single internal opening while 4 patients had multiple internal openings. 3 patients had multiple(two) perianal fistula, 9 patients had complex fistula in form either multiple internal openings or multiple external openings. 38 patients had simple fistula. 40 tracts were low anal fistula while 10 tracts were high anal fistula-involving puborectalis sling and levator plate, about 17 fistulas showed abscess formation. Conclusion: MRI is imaging modality of choice in preoperative evaluation of perianal fistulae, especially in complex and recurrent cases. MRI Fistulogram is recommended in recurrent and complex cases as a method of pre-operative evaluation, for surgical outcome and planning and hence to reduce recurrences.

Objective: To asses role of MRI in perianal fissure and fistula and to evaluate complications. Materials and Methods: Total 50 patients, who were clinically diagnosed as suffering from perianal fissure/fistula, were recruited. Each patient was studied in detail with relevant clinical history and Examination. MRI was performed on 1.5 T Philips scanner with patient in prone position using body coil, no special bowel preparation was used. Results: A total of 50 cases of perianal fissure/fistula, most patients were in age group of 31 to 50 years, 43 patients were males (86%) & 7 patients were females (14%). 3 cases (6%) had previous operative history for perianal fistula and shows recurrence. 36(72%) tracts were trans-sphincteric type followed by inter-sphincteric type (13, 26%) & 1 (2%) fistula was of supra-sphincteric type. grade IV fistulas were found in 19 cases (38%), grade III fistulas found in 17 cases (34%), grade I & grade II fistulas were found in 7 cases (14%) & 6 cases (12%) respectively & grade V fistulas in 1 patient (2%). 41 patients had single external opening while 7 patient had multiple external openings. One patient had sub mucosal fissure and one patient had only internal opening(sinus) disease. 44 patients had single internal opening while 4 patients had multiple internal openings. 3 patients had multiple(two) perianal fistula, 9 patients had complex fistula in form either multiple internal openings or multiple external openings. 38 patients had simple fistula. 40 tracts were low anal fistula while 10 tracts were high anal fistula-involving puborectalis sling and levator plate, about 17 fistulas showed abscess formation. Conclusion: MRI is imaging modality of choice in preoperative evaluation of perianal fistulae, especially in complex and recurrent cases. MRI Fistulogram is recommended in recurrent and complex cases as a method of pre-operative evaluation, for surgical outcome and planning and hence to reduce recurrences.