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Chronic anal fissure: morphometric analysis of the anal canal at 3.0 Tesla MR imaging

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Abstract

Objectıve

To compare the morphometric data relating to the muscular structures of the anal canal, in patients with chronic anal fissure and in control group, examined at a 3.0 Tesla MR system.

Subjects and methods

Forty-seven consecutive patients with chronic anal fissure and randomly selected 40 patients who had no claims for perianal disease during their life time were included in the study. T2-weighted sagittal, high-resolution (HR) T2-weighted, and contrast-enhanced fat-suppressed T1-weighted oblique axial and oblique coronal images were retrospectively analyzed by two observers in consensus. Thickness of sphincteric muscles, anal canal length, anorectal angle, thickness of anococcygeal ligament, depth of Minor triangle, width between subcutaneous sphincters, vascularity of posterior commissure, visibility of posterosuperior projection of external sphincter, and angle between the distal anal canal and posterosuperior projection of external sphincter (H angle) in patients and in controls were compared and analyzed using t test, Mann–Whitney U test, and Spearman correlation.

Results

The patients with chronic anal fissure had longer anal canal (51.50 mm ± 0.91 vs. 44.11 mm ± 0.71; p = 0.000), thicker internal anal sphincter muscle at mid-anal level (4.18 ± 0.15 vs. 3.39 ± 0.07; p = 0.007), and wider space between subcutaneous external sphincters (11.39 ± 0.50 vs. 6.89 ± 0.22; p = 0.000). In patients, there was a positive correlation between H angle and external sphincter thickness at proximal (r = 0.347; p = 0.021), middle (r = 0427; p = 0.000), and distal (r = 0.518; p = 0.000)) levels of the anal canal.

Conclusıon

3.0 Tesla MR imaging provides detailed information about the morphometric changes in the anal sphincter muscles in patients with chronic anal fissure.

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Authors and Affiliations

  1. Department of Radiology, School of Medicine, Ankara University, Talatpaşa Bulvarı, Sıhhiye, 06100, Ankara, Turkey

    Ayşe Erden & Elif Peker

  2. Department of Biostatistics, School of Medicine, Ankara University, Ankara, Turkey

    Zeynep Bıyıklı Gençtürk

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  1. Ayşe Erden
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  2. Elif Peker
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Correspondence to Ayşe Erden.

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Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board.

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Erden, A., Peker, E. & Gençtürk, Z.B. Chronic anal fissure: morphometric analysis of the anal canal at 3.0 Tesla MR imaging. Abdom Radiol 42, 423–434 (2017). https://doi.org/10.1007/s00261-016-0893-6

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  • DOI: https://doi.org/10.1007/s00261-016-0893-6

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