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

Dariusz Waniczek, Tomasz Adamczyk, Jerzy Arendt, Ewa Kluczewska

Department of Surgery Propedeutics, Clinical Department of General, Colorectal and Trauma Surgery, Medical University of Silesia, Sosnowiec, Poland

Med Sci Monit 2015; 21:439-445

DOI: 10.12659/MSM.891232

Available online:

Published: 2015-02-10

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.

Keywords: Gadolinium - diagnostic use, Female, Adult, Humans, Hydrogen Peroxide - diagnostic use, Magnetic Resonance Imaging - methods, Male, Middle Aged, Rectal Fistula - pathology, Recurrence