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Predictors of Outcome in Cryptoglandular Anal Fistula According to Magnetic Resonance Imaging: A Systematic Review Publisher



Teymouri A1 ; Keshvari A2 ; Ashjaei A3 ; Ahmadi Tafti SM2 ; Salahshour F4 ; Khorasanizadeh F4 ; Naseri A1
Authors
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Authors Affiliations
  1. 1. Department of Colorectal Surgery, Imam Reza Hospital, Aja University of Medical Sciences, Tehran, Iran
  2. 2. Department of Surgery, Colorectal Research Center, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Surgery, Besat Hospital, Aja University of Medical Sciences, Tehran, Iran
  4. 4. Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran

Source: Health Science Reports Published:2023


Abstract

Background and Aims: Anal fistula (AF) with cryptoglandular origin tends to recur, and multiple risk factors are implicated. Recently, some magnetic resonance imaging (MRI) findings with predictive value for disease outcomes have been proposed. These intrinsic anatomic features include those of the AF and its surrounding structures. This study aims to clarify the prognostic role of MRI in AF. Methods: We performed a systematic search of PubMed, Embase, and EBSCO databases. Two independent reviewers conducted the search and screened the articles. We selected studies that used MRI to assess AF and reported its relationship to disease outcome. We extracted data regarding the study design, type of intervention, outcome, MRI-measured items, and their significance. Results: Out of 1230 retrieved articles, 18 were eligible for final inclusion, and a total of 4026 patients were enrolled in the selected studies. For preoperative MRI, the significant items affecting the outcome were the length of the fistula, horseshoe type, presence of multiple tracts, supralevator extension, and apparent diffusion coefficient (ADC) value. Other studies investigated the healing process using postoperative MRI. Conclusion: This review found that MRI can be useful in the management of AF, both preoperatively and postoperatively. Factors, such as fistula length, horseshoe type, presence of multiple tracts, supralevator extension, and ADC value were found to be significantly associated with treatment outcomes. The presence of the fistula tract and the development of new abscesses on postoperative MRI was found to hinder the healing process. Further studies are needed to confirm these findings. © 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC.
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