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Perianal fistüllerin manyetik rezonans görüntüleme ile değerlendirilmesi: T2 ağırlıklı BLADE sekansının hastalık tanısında önemi

Year 2021, Volume: 6 Issue: 1, 27 - 31, 30.03.2021
https://doi.org/10.25000/acem.882429

Abstract

Giriş ve Amaç: Manyetik Rezonans Görüntüleme (MRG) ile perianal fistül teşhisinde, T2-ağırlıklı (A) BLADE sekansın etkinliğini, T2-A Turbo Spin Eko (TSE) sekans ile karşılaştırmak ve bulguları, rutin pelvik MRG incelemede Dinamik Kontrastlı (DCE) T1-A sekans görüntüleri ile karşılaştırmak.
Gereç ve Yöntemler: Perianal fistül ön tanısı ile pelvik MRG incelemesi (1.5Tesla) yapılan toplam 90 hasta prospektif çalışmamıza dahil edildi. Rutin pelvik MRG protokolümüze, üç planda T2A BLADE sekansı ve T2A TSE sekansları da dahil edildi. Perianal fistül tanısında T2A BLADE sekans ve T2A TSE sekansların üstünlüğünü birbiriyle ve ardından üç aşamalı skorlama ile DCE T1A sekans ile karşılaştırıldı. Değerlendirme iki radyolog tarafından, farklı zamanlarda ve birbirinden bağımsız olarak yapıldı. İstatistiksel analiz için Simple t-test ve Cronbach's Alpha testi kullanıldı.
Bulgular: Perianal fistül tanısında, T2A BLADE sekans ile T2A TSE sekansa göre daha kısa sürede ve artefaktlara daha az duyarlı, yüksek çözünürlüklü görüntüler elde edildi(p <0.05). T2A BLADE sekans ile DCE T1A sekansına benzer yüksek kontrast çözünürlüğü olan görüntüler elde edildi (p <0.05).
Sonuç: Daha kısa sürede ve yüksek çözünürlüklü görüntüler elde edebilmesi nedeniyle, perianal fistül tanısında T2A görüntüler BLADE tekniği ile elde edilebilir.

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References

  • Erden A. MRI of the anal canal: normal anatomy, imaging protocol, and perianal fistulas: part 1. Abdom Radiol 2018;43:1334-1352.
  • De Miguel C J, del Salto LG, Rivas PF et al.MR imaging evaluation of perianal fistulas : spectrum of imaging features. Radiographics 2012;32:175-194.
  • Choudhary J, Kaushal L, Rajput P. Role of Magnetic Resonance Imaging in Evaluation of Perianal Fistula. Int J Sci Stud 2020;8:90-94.
  • Visscher AP, Felt-Bersama RJ. Endoanal ultrasound in perianal fistulae and abscesses. Ultrasound Q 2015;31:130-137.
  • Zand KR, Reinhold C, Haider MA et al. Artifacts and pitfalls in MR imaging of the pelvis; J Magn Reson Imaging 2007; 26:480-497.
  • Keogan MT, Edelman RR. Technologic advances in abdominal MR imaging. Radiology 2001; 220:310-320.
  • Pandit P, Qi Y, King KF et al. Reduction of artifacts in T2 -weighted PROPELLER in high-field preclinical imaging.Magn Reson Med 2011;65:538-543.
  • Hirokawa Y, Isoda H, Maetani YS et al. Evaluation of motion correction effect and image quality with the periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) (BLADE) and parallel imaging acquisition technique in the upper abdomen. J. Magn. Reson. Imaging 2008;28:957–962.
  • Tamhane AA, Arfanakis K. Motion correction in periodically-rotated overlapping parallel lines with enhanced reconstruction ( PROPELLER ) and turboprop MRI. Magn Reson Med. 2009;62:174-182.
  • Ciet P, Serra G, Bertolo S et al. Assessment of CF lung disease using motion-corrected PROPELLER MRI: a comparison with CT. Eur Radiol 2016;26:780-787.
  • Ohgiya Y, Suyama J, Seino N et al. MRI of the Neck at 3 Tesla Using the Periodically Rotated Overlapping Parallel Lines with Enhanced Reconstruction (PROPELLER) (BLADE) Sequence Compared with T2-Weighted Fast Spin-Echo Sequence. J. Magn. Reson. Imaging 2010;32:1061–1067.
  • Lane BF, Vandermeer FQ, Oz RC et al. Comparison of sagittal T2-weighted BLADE and fast spin-echo MRI of the female pelvis for motion artifact and lesion detection. Am J Roentgenol 2011;197:307-313.
  • Sahnan K, Adegbola SO, Tozer PJ et al. Innovation in the imaging perianal fistula: a step towards personalized medicine. Therapy Adv Gastroenterol 2018;11:1–7.
  • Almeida IS, Jayarajah U, Wickramasinghe DP et al.Value of three-dimensional endoanal ultrasound scan (3D-EAUS) in preoperative assessment of fistula-in-ano. BMC Res Notes 2019;12: 66.

Evaluation of perianal fistulas with magnetic resonance imaging: Significance of T2-weighted BLADE sequence in disease diagnosis

Year 2021, Volume: 6 Issue: 1, 27 - 31, 30.03.2021
https://doi.org/10.25000/acem.882429

Abstract

Introduction: Anatomical details of perianal fistulas can be revealed more clearly by T2-weighted (T2-W) periodically rotated overlapping parallel lines with enhanced reconstruction (BLADE)sequence during magnetic resonance imaging (MRI). This study aimed to compare the efficacy of the T2-W BLADE sequence and the T2-W turbo spin-echo (TSE) sequence in diagnosing perianal fistula, as well as to compare the findings with the results obtained using the dynamic contrast-enhanced (DCE) T1-weighted (T1-W) sequence during routine pelvic MRI examination.
Methods: Ninety patients (M/F: 67/23) who had undergone pelvic MRI examination (1.5Tesla) for the prediagnosis of perianal fistula were included in this prospective study.
In addition to our routine pelvic MRI protocol, T2-W BLADE sequence imaging and T2-W TSE sequence imaging in the axial, sagittal, and coronal planes were performed. Using a three-stage scoring system, two radiologists independently compared the T2-W BLADE and T2-W TSE sequences with each other and then with the DCE T1-W sequence in terms of perianal fistula imaging. Statistical analysis was performed using a sample t-test and the Cronbach’s α test.
Results: Compared with the T2-W TSE sequence, the T2-W BLADE sequence was associated with fewer ghosting artifacts, higher overall image quality, and with clearer visualization of the anatomical details of the perianal fistula (p < 0.05). Images with high anatomic details and contrast resolution were obtained using the T2-W BLADE sequence similar to those obtained using the DCE T1-W sequence (p < 0.05).
Conclusion: On the basis of the reduced imaging time and on the higher image resolution, T2-W images can be obtained with the BLADE technique for the diagnosis of perianal fistula.

References

  • Erden A. MRI of the anal canal: normal anatomy, imaging protocol, and perianal fistulas: part 1. Abdom Radiol 2018;43:1334-1352.
  • De Miguel C J, del Salto LG, Rivas PF et al.MR imaging evaluation of perianal fistulas : spectrum of imaging features. Radiographics 2012;32:175-194.
  • Choudhary J, Kaushal L, Rajput P. Role of Magnetic Resonance Imaging in Evaluation of Perianal Fistula. Int J Sci Stud 2020;8:90-94.
  • Visscher AP, Felt-Bersama RJ. Endoanal ultrasound in perianal fistulae and abscesses. Ultrasound Q 2015;31:130-137.
  • Zand KR, Reinhold C, Haider MA et al. Artifacts and pitfalls in MR imaging of the pelvis; J Magn Reson Imaging 2007; 26:480-497.
  • Keogan MT, Edelman RR. Technologic advances in abdominal MR imaging. Radiology 2001; 220:310-320.
  • Pandit P, Qi Y, King KF et al. Reduction of artifacts in T2 -weighted PROPELLER in high-field preclinical imaging.Magn Reson Med 2011;65:538-543.
  • Hirokawa Y, Isoda H, Maetani YS et al. Evaluation of motion correction effect and image quality with the periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) (BLADE) and parallel imaging acquisition technique in the upper abdomen. J. Magn. Reson. Imaging 2008;28:957–962.
  • Tamhane AA, Arfanakis K. Motion correction in periodically-rotated overlapping parallel lines with enhanced reconstruction ( PROPELLER ) and turboprop MRI. Magn Reson Med. 2009;62:174-182.
  • Ciet P, Serra G, Bertolo S et al. Assessment of CF lung disease using motion-corrected PROPELLER MRI: a comparison with CT. Eur Radiol 2016;26:780-787.
  • Ohgiya Y, Suyama J, Seino N et al. MRI of the Neck at 3 Tesla Using the Periodically Rotated Overlapping Parallel Lines with Enhanced Reconstruction (PROPELLER) (BLADE) Sequence Compared with T2-Weighted Fast Spin-Echo Sequence. J. Magn. Reson. Imaging 2010;32:1061–1067.
  • Lane BF, Vandermeer FQ, Oz RC et al. Comparison of sagittal T2-weighted BLADE and fast spin-echo MRI of the female pelvis for motion artifact and lesion detection. Am J Roentgenol 2011;197:307-313.
  • Sahnan K, Adegbola SO, Tozer PJ et al. Innovation in the imaging perianal fistula: a step towards personalized medicine. Therapy Adv Gastroenterol 2018;11:1–7.
  • Almeida IS, Jayarajah U, Wickramasinghe DP et al.Value of three-dimensional endoanal ultrasound scan (3D-EAUS) in preoperative assessment of fistula-in-ano. BMC Res Notes 2019;12: 66.
There are 14 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Original Research
Authors

Safiye Sanem Dereli Bulut 0000-0003-4593-6227

Zakir Sakcı 0000-0002-5144-3851

Publication Date March 30, 2021
Published in Issue Year 2021 Volume: 6 Issue: 1

Cite

Vancouver Dereli Bulut SS, Sakcı Z. Evaluation of perianal fistulas with magnetic resonance imaging: Significance of T2-weighted BLADE sequence in disease diagnosis. Arch Clin Exp Med. 2021;6(1):27-31.