Abstract
Complex fistulizing perianal Crohn’s disease (pCD) is a challenging affliction to manage. Imaging alongside clinical examination helps the clinician elucidate the morphology of the fistula which is one of the first steps of forming a management strategy. MRI is and remains the gold standard investigation and can be used to plan interventions and even further along the management pathway to assess the effect of the healing intervention.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Adegbola SO et al (2018) Medical and surgical management of perianal Crohn’s disease. Ann Gastroenterol 31:129–139
Adegbola SO et al (2020) Current review of the management of fistulising perianal Crohn’s disease. Frontline Gastroenterol. https://doi.org/10.1136/flgastro-2020-101489
Barnhoorn MC et al (2020) Long-term evaluation of allogeneic bone marrow-derived mesenchymal stromal cell therapy for Crohn’s disease perianal fistulas. J Crohns Colitis 14:64–70
Beckingham IJ et al (1996) Prospective evaluation of dynamic contrast enhanced magnetic resonance imaging in the evaluation of fistula in ano. Br J Surg 83:1396–1398
Beets-Tan RGH et al (2001) Preoperative MR imaging of anal fistulas: does it really help the surgeon? Radiology 218:75–84
Bianchi L et al (2019) 3D reconstruction and physical renal model to improve percutaneous punture during PNL. Int Braz J Urol 45:1281–1282
Buchanan G et al (2002) Effect of MRI on clinical outcome of recurrent fistula-in-ano. Lancet 360:1661–1662
Buchanan GN et al (2004) Clinical examination, endosonography, and MR imaging in preoperative assessment of fistula in ano: comparison with outcome-based reference standard. Radiology 233:674–681
Chambaz M et al (2019) Deep remission on magnetic resonance imaging impacts outcomes of perianal fistulizing Crohn’s disease. Dig Liver Dis 51:358–363
Cheifetz AS (2013) Management of active Crohn disease. JAMA 309:2150
Choen S, Phillips RKS (1991) Insights gained from the management of problematical anal fistulae at St. Mark’s Hospital, 1984–88. Br J Surg 78:539–541
Dagia C, Ditchfield M, Kean M, Catto-Smith A (2010) Feasibility of 3-T MRI for the evaluation of Crohn disease in children. Pediatr Radiol 40:1615–1624
Darbari A et al (2004) Gadolinium-enhanced magnetic resonance imaging: a useful radiological tool in diagnosing pediatric IBD. Inflamm Bowel Dis 10:67–72
Essary B, Kim J, Anupindi S, Katz AJ, Nimkin K (2007) Pelvic MRI in children with Crohn disease and suspected perianal involvement. Pediatr Radiol 37:201–208
Garros A et al (2014) Magnetic resonance imaging and clinical assessments for perianal Crohn’s disease: gain and limits. Dig Liver Dis 46:1072–1076
Gionchetti P et al (2017) 3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016: Part 2: surgical management and special situations on behalf of ECCO. J Crohns Colitis 11:135–149. https://doi.org/10.1093/ecco-jcc/jjw169
Hindryckx P et al (2019) Development and validation of a magnetic resonance index for assessing fistulas in patients with Crohn’s disease. Gastroenterology 157:1233–1244.e5
Horsthuis K et al (2011) Evaluation of an MRI-based score of disease activity in perianal fistulizing Crohn’s disease. Clin Imaging 35:360–365
Jones J, Tremaine W (2005) Evaluation of perianal fistulas in patients with Crohn’s disease. MedGenMed 7:16
Keighley MR, Allan RN (1986) Current status and influence of operation on perianal Crohn’s disease. Int J Color Dis 1:104–107
King D et al (2020) Changing patterns in the epidemiology and outcomes of inflammatory bowel disease in the United Kingdom: 2000–2018. Aliment Pharmacol Ther 51:922–934
Laghi A et al (2003) Contrast enhanced magnetic resonance imaging of the terminal ileum in children with Crohn’s disease. Gut 52:393–397
Lee H et al (2017) Fully automated deep learning system for bone age assessment. J Digit Imaging 30:427–441
Li P et al (2018) The 3D reconstructions of female pelvic autonomic nerves and their related organs based on MRI: a first step towards neuronavigation during nerve-sparing radical hysterectomy. Eur Radiol 28:4561–4569
Lung PFC et al (2018) Volume assessment magnetic resonance imaging technique for monitoring perianal Crohn’s fistulas. Ther Adv Gastroenterol 11:1–8
Magnano G et al (2003) Polyethylene glycol and contrast-enhanced MRI of Crohn’s disease in children: preliminary experience. Pediatr Radiol 33:385–391
Mahadev S, Young JM, Selby W, Solomon MJ (2011) Quality of life in perianal Crohn’s disease: what do patients consider important? Dis Colon Rectum 54:579–585
Mahapatra D et al (2013) Automatic detection and segmentation of Crohn’s disease tissues from abdominal MRI. IEEE Trans Med Imaging 32:2332–2347
Morris J, Spencer JA, Ambrose NS (2000) MR imaging classification of perianal fistulas and its implications for patient management. Radiographics 20:623–635
Ng SC et al (2009) Prospective evaluation of anti-tumor necrosis factor therapy guided by magnetic resonance imaging for Crohn’s perineal fistulas. Am J Gastroenterol 104:2973–2986
Parks AG, Gordon PH, Hardcastle JD (1976) A classification of fistula-in-ano. Br J Surg 63:1–12
Pikarsky AJ, Gervaz P, Wexner SD (2002) Perianal Crohn disease. Arch Surg 137:3–7
Present DH et al (1999) Infliximab for the treatment of fistulas in patients with Crohn’s disease. N Engl J Med 340:1398–1405
Rincón M et al (2017) Improved automatic segmentation of white matter hyperintensities in MRI based on multilevel lesion features. Neuroinformatics 15:231–245
Sahnan K et al (2018a) Improving the understanding of perianal Crohn fistula through 3D modeling. Ann Surg 267:e105–e107
Sahnan K et al (2018b) Innovation in the imaging perianal fistula: a step towards personalised medicine. Ther Adv Gastroenterol 11:1756284818775060
Sahnan K et al (2019a) Developing a core outcome set for fistulising perianal Crohn’s disease. Gut 68:226–238
Sahnan K et al (2019b) The use of 3D imaging to facilitate training during complex fistula surgery – a video vignette. Color Dis 21:376
Sahni VA, Ahmad R, Burling D (2008) Which method is best for imaging of perianal fistula? Abdom Imaging 33:26–30
Samaan MA et al (2017) The development of a magnetic resonance imaging index for fistulising Crohn’s disease. Aliment Pharmacol Ther 46:516–528
Sands BE, Blank MA, Patel K, Van Deventer SJ (2004) Long-term treatment of rectovaginal fistulas in Crohn’s disease: response to infliximab in the ACCENT II study. Clin Gastroenterol Hepatol 2:912–920
Scholefield JH, Berry DP, Armitage NC, Wastie ML (1997) Magnetic resonance imaging in the management of fistula in ano. Int J Color Dis 12:276–279
Schwartz DA et al (2001) A comparison of endoscopic ultrasound, magnetic resonance imaging, and exam under anesthesia for evaluation of Crohn’s perianal fistulas. Gastroenterology 121:1064–1072
Schwartz DA et al (2002) The natural history of fistulizing Crohn’s disease in Olmsted County, Minnesota. Gastroenterology 122:875–880
Spencer JA et al (1998) Outcome after surgery for perianal fistula: predictive value of MR imaging. Am J Roentgenol 171:403–406
Tang ST et al (2009) Clinical value of pelvic 3-dimensional magnetic resonance image reconstruction in anorectal malformations. J Pediatr Surg 44:2369–2374
Tarrant KM, Barclay ML, Frampton CMA, Gearry RB (2008) Perianal disease predicts changes in Crohn’s disease phenotype-results of a population-based study of inflammatory bowel disease phenotype. Am J Gastroenterol 103:3082–3093
Tozer PJ, Burling D, Gupta A, Phillips RKS, Hart AL (2011) Review article: medical, surgical and radiological management of perianal Crohn’s fistulas. Aliment Pharmacol Ther 33:5–22
Tozer P et al (2012) Long-term MRI-guided combined anti-TNF-α and thiopurine therapy for Crohn’s perianal fistulas. Inflamm Bowel Dis 18:1825–1834
Van Assche G et al (2003) Magnetic resonance imaging of the effects of infliximab on perianal fistulizing Crohn’s disease. Am J Gastroenterol 98:332–339
van Rijn KL et al (2020) Evaluation of the modified Van Assche index for assessing response to anti-TNF therapy with MRI in perianal fistulizing Crohn’s disease. Clin Imaging 59:179–187
Villa C et al (2012) Role of magnetic resonance imaging in evaluation of the activity of perianal Crohn’s disease. Eur J Radiol 81:616–622
Wake N, Wysock JS, Bjurlin MA, Chandarana H, Huang WC (2019) “Pin the tumor on the kidney:” an evaluation of how surgeons translate CT and MRI data to 3D models. Urology 131:255–261
Zeng C, Xing W, Wu Z, Huang H, Huang W (2016) A combination of three-dimensional printing and computer-assisted virtual surgical procedure for preoperative planning of acetabular fracture reduction. Injury 47:2223–2227
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Section Editor information
Rights and permissions
Copyright information
© 2022 Springer Nature Switzerland AG
About this entry
Cite this entry
Vincent, M., Lung, P.F.C., Sahnan, K. (2022). Magnetic Resonance Imaging in the Diagnosis, Characterization, and Management of Crohn’s Fistula. In: Ratto, C., Parello, A., Litta, F., De Simone, V., Campennì, P. (eds) Anal Fistula and Abscess. Coloproctology. Springer, Cham. https://doi.org/10.1007/978-3-030-76670-2_15
Download citation
DOI: https://doi.org/10.1007/978-3-030-76670-2_15
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-76669-6
Online ISBN: 978-3-030-76670-2
eBook Packages: MedicineReference Module Medicine