Magnetic resonance imaging findings in patients with initial manifestations of perianal fistulas.
Journal
Annals of Saudi medicine
ISSN: 0975-4466
Titre abrégé: Ann Saudi Med
Pays: Saudi Arabia
ID NLM: 8507355
Informations de publication
Date de publication:
Historique:
entrez:
7
2
2020
pubmed:
7
2
2020
medline:
29
1
2021
Statut:
ppublish
Résumé
Crohn's disease (CD) is a serious cause of perianal disease and the incidence is increasing in Saudi Arabia. MR imaging may document specific features that may help to foresee Crohn's disease in patients making an initial presentation. Present MR imaging findings of perianal fistulas in patients making an initial presentation. Retrospective, observational. Radiology clinic in in Dhahran. All previously undiagnosed and untreated patients who presented for the first time to the outpatient clinics from September 2015-2018 with perianal fistulas were retrospectively evaluated. Previously diagnosed CD patients, post-surgical or intervention cases were excluded. Fistulas were categorized as low or high anal, simple or complex, and were graded per St. James University Hospital Classification. Imaging was interpreted by two experienced readers based on the Van Assche score. Fistula features on MR imaging and diagnosis of CD. 171 patients. Of 171 patients, 139 (81.3%) were males with mean age of 37.2 (12.7) years; the 32 females had a mean age of 35.8 (10.6) years. Twenty-one patients (12.3%) had CD. Fourteen (40.4%) patients with complex fistulas had CD in comparison to only 5 (4.8%) simple fistula patients ( P=.0005). More than half of patients with complex and high anal fistulas had CD ( P=.0005). Females were more affected than males ( P=.0005). Complex or high anal fistula on MR imaging may be the initial presentation of CD and warrant further work up to establish the diagnosis. Retrospective, small sample, single center, and short duration study. None.
Sections du résumé
BACKGROUND
BACKGROUND
Crohn's disease (CD) is a serious cause of perianal disease and the incidence is increasing in Saudi Arabia. MR imaging may document specific features that may help to foresee Crohn's disease in patients making an initial presentation.
OBJECTIVE
OBJECTIVE
Present MR imaging findings of perianal fistulas in patients making an initial presentation.
DESIGN
METHODS
Retrospective, observational.
SETTING
METHODS
Radiology clinic in in Dhahran.
PATIENTS AND METHODS
METHODS
All previously undiagnosed and untreated patients who presented for the first time to the outpatient clinics from September 2015-2018 with perianal fistulas were retrospectively evaluated. Previously diagnosed CD patients, post-surgical or intervention cases were excluded. Fistulas were categorized as low or high anal, simple or complex, and were graded per St. James University Hospital Classification. Imaging was interpreted by two experienced readers based on the Van Assche score.
MAIN OUTCOME MEASURES
METHODS
Fistula features on MR imaging and diagnosis of CD.
SAMPLE SIZE
METHODS
171 patients.
RESULTS
RESULTS
Of 171 patients, 139 (81.3%) were males with mean age of 37.2 (12.7) years; the 32 females had a mean age of 35.8 (10.6) years. Twenty-one patients (12.3%) had CD. Fourteen (40.4%) patients with complex fistulas had CD in comparison to only 5 (4.8%) simple fistula patients ( P=.0005). More than half of patients with complex and high anal fistulas had CD ( P=.0005). Females were more affected than males ( P=.0005).
CONCLUSION
CONCLUSIONS
Complex or high anal fistula on MR imaging may be the initial presentation of CD and warrant further work up to establish the diagnosis.
LIMITATIONS
CONCLUSIONS
Retrospective, small sample, single center, and short duration study.
CONFLICT OF INTEREST
BACKGROUND
None.
Identifiants
pubmed: 32026703
doi: 10.5144/0256-4947.2020.42
pmc: PMC7012033
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
42-48Références
Br J Surg. 2017 Dec;104(13):1857-1865
pubmed: 28857130
Z Gastroenterol. 2019 May;57(5):574-583
pubmed: 30873578
Saudi Med J. 2013 Nov;34(11):1105-13
pubmed: 24252887
Diagn Interv Radiol. 2019 Jan;25(1):21-27
pubmed: 30582572
Inflamm Bowel Dis. 2017 Sep;23(9):1659-1665
pubmed: 28590344
Dig Dis Sci. 2018 May;63(5):1102-1122
pubmed: 29549474
Ultraschall Med. 2017 Jun;38(3):265-272
pubmed: 28399604
Abdom Radiol (NY). 2019 Mar;44(3):811-820
pubmed: 30519819
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2019 Feb 28;44(2):173-179
pubmed: 30837386
Therap Adv Gastroenterol. 2018 May 24;11:1756284818775060
pubmed: 29854001
Aliment Pharmacol Ther. 2017 Sep;46(5):516-528
pubmed: 28653753
J Magn Reson Imaging. 2018 Jun;47(6):1638-1645
pubmed: 29135086
Radiologe. 2018 Apr;58(4):344-354
pubmed: 29464273
Clin Exp Gastroenterol. 2017 Feb 08;10:39-46
pubmed: 28223835
Ann Gastroenterol. 2017;30(1):33-44
pubmed: 28042236
Radiol Clin North Am. 2018 Sep;56(5):775-789
pubmed: 30119773
World J Gastroenterol. 2015 Feb 7;21(5):1394-403
pubmed: 25663759
Radiology. 2017 Mar;282(3):628-645
pubmed: 28218881
Abdom Radiol (NY). 2019 May;44(5):1744-1755
pubmed: 30770939
Eur Radiol. 2019 Sep;29(9):5082-5092
pubmed: 30729332
Rev Col Bras Cir. 2019 Jan 07;45(6):e1840
pubmed: 30624518
Int J Surg. 2017 Jun;42:34-40
pubmed: 28414118
Diagn Interv Radiol. 2018 Nov;24(6):321-327
pubmed: 30272562
Pol J Radiol. 2016 Dec 22;81:611-617
pubmed: 28096904
Korean J Radiol. 2019 Mar;20(3):429-437
pubmed: 30799574
Pediatr Gastroenterol Hepatol Nutr. 2017 Mar;20(1):14-21
pubmed: 28401051
Saudi J Gastroenterol. 2017 Jul-Aug;23(4):213-215
pubmed: 28721973
J Pediatr Gastroenterol Nutr. 2018 Apr;66(4):614-619
pubmed: 28953535
Medicine (Baltimore). 2018 Jul;97(29):e11570
pubmed: 30024560
Saudi J Gastroenterol. 2013 Jan-Feb;19(1):16-22
pubmed: 23319033
Abdom Radiol (NY). 2019 Feb;44(2):446-455
pubmed: 30159595
Curr Probl Diagn Radiol. 2017 Mar - Apr;46(2):110-114
pubmed: 28062089
Am J Surg. 2019 May;217(5):910-917
pubmed: 30773213
Arq Bras Cir Dig. 2019 Feb 07;32(1):e1420
pubmed: 30758468
Ann Saudi Med. 2012 May-Jun;32(3):276-82
pubmed: 22588439
Pol J Radiol. 2017 Sep 15;82:516-523
pubmed: 29662582