Diffusion-weighted MRI for evaluating perianal fistula activity: feasibility study.

Abstract

PURPOSE:

To assess the feasibility of using diffusion-weighted magnetic resonance (MR) imaging (DWI) for evaluating perianal fistula activity.

MATERIALS AND METHODS:

This study retrospectively assessed 24 patients with clinically suspected perianal fistula who underwent a total of 28 MR examinations after conservative treatment with antibiotics. DWI was performed at 1.5 T, using b-values of 0 and 1000 s/mm(2). Apparent diffusion coefficient (ADC) maps were created and ADCs of the lesions were measured. Lesions were classified into two groups based on the need for surgery and surgical findings: positive inflammation activity (PIA) and negative inflammation activity (NIA). ADCs of both groups were compared using an unpaired t-test, and Receiver Operating Characteristic (ROC) analysis was performed.

RESULTS:

The ADC (in 10(-3) mm(2)/s) of the PIA group (0.908±0.171) was significantly lower (P=0.0019) than that of the NIA group (1.124±0.244). The area under the ROC curve was 0.749. An optimal cut-off ADC of 1.109 yielded a sensitivity of 95.7%, a specificity of 50%, a positive predictive value of 71%, and a negative predictive value of 90%.

CONCLUSION:

DWI is a feasible method for evaluating perianal fistula activity. The diagnostic performance of this technique should be established in future, larger prospective studies.

• Authors: Takeshi Yoshizako, Akihiko Wada, Taro Takahara, Thomas C Kwee, Megumi Nakamura, Koji Uchida, Shinji Hara, Peter R Luijten, Hajime Kitagaki
• Journal: European journal of radiology (Eur J Radiol) Vol. 81 Issue 9 Pg. 2049-53 (Sep 2012) ISSN: 1872-7727 [Electronic] Ireland
• PMID: 21767926 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Topics

• Adult
• Aged
• Anal Canal (abnormalities, pathology)
• Diffusion Magnetic Resonance Imaging (methods)
• Feasibility Studies
• Female
• Humans
• Intestinal Fistula (pathology)
• Male
• Middle Aged
• Reproducibility of Results
• Sensitivity and Specificity