Direct MRI Fistulography with Hydrogen Peroxide in Patients with Recurrent Perianal Fistulas: A New Proposal of Extended Diagnostics

BACKGROUND Perianal fistulas are malformations of the anorectal area. Accurate preoperative assessment of perianal fistula tract is a main assumption in diagnosis of the disease, affecting the operation efficiency. The aim of the study was to present our experience in application of a new diagnostic protocol based on the magnetic resonance imaging (MRI) examination using a mixture of hydrogen peroxide (HP) and gadolinium as a direct contrast medium in evaluation of recurrent fistulas tract. The method is referred to as HPMRI. MATERIAL AND METHODS The study group consisted of 12 subjects operated on from 2011. Direct HPMRI fistulography was performed in all subjects before the operation. All types of fistulas were precisely evaluated by HPMRI examination. RESULTS Intraoperative state confirmed complete course of fistulas in 11 cases. In 1 case, an internal opening was not found. CONCLUSIONS We suggest that this new method of direct HPMRI fistulography may improve visualization of the tracts of recurrent fistulas and improve efficacy of surgical procedures.