Alves J.C.G., Sidler D., Lotz J.W., Pitcher R.D.
Department of Medical Imaging and Clinical Oncology, Tygerberg Academic Hospital, Stellenbosch University, Francie van Zyl Avenue, Parow Valley, Cape Town 7700, South Africa; Department of Surgical Sciences, Tygerberg Academic Hospital, Stellenbosch University, Cape Town, South Africa
Alves, J.C.G., Department of Medical Imaging and Clinical Oncology, Tygerberg Academic Hospital, Stellenbosch University, Francie van Zyl Avenue, Parow Valley, Cape Town 7700, South Africa; Sidler, D., Department of Surgical Sciences, Tygerberg Academic Hospital, Stellenbosch University, Cape Town, South Africa; Lotz, J.W., Department of Medical Imaging and Clinical Oncology, Tygerberg Academic Hospital, Stellenbosch University, Francie van Zyl Avenue, Parow Valley, Cape Town 7700, South Africa; Pitcher, R.D., Department of Medical Imaging and Clinical Oncology, Tygerberg Academic Hospital, Stellenbosch University, Francie van Zyl Avenue, Parow Valley, Cape Town 7700, South Africa
Background: Anorectal malformations are often associated with rectal pouch fistulas. Surgical correction requires accurate evaluation of the presence and position of such fistulas. Fluoroscopy is currently the chosen modality for the detection of fistulas. The role of MRI is unexplored. Objective: To compare the diagnostic accuracy of MR versus fluoroscopic fistulography in the pre-operative evaluation of infants with anorectal malformation. Materials and methods: We conducted a pilot study of infants requiring defunctioning colostomy for initial management of anorectal malformation. Dynamic sagittal steady-state free-precession MRI of the pelvis was acquired during introduction of saline into the mucous fistulas. Findings were compared among MR fistulography, fluoroscopic fistulography and intraoperative inspection. Results: Eight children were included. Median age at fistulography was 15 weeks, inter-quartile range 13-20 weeks; all were boys. There was full agreement among MR fistulography, fluoroscopic fistulography and surgical findings. Conclusion: The pilot data suggest that MR fistulography is promising in the pre-operative evaluation of children with anorectal malformation. © 2013 Springer-Verlag Berlin Heidelberg.
anorectal malformation; article; clinical article; colostomy; comparative effectiveness; diagnostic accuracy; diagnostic imaging; diagnostic test accuracy study; fistulography; fluoroscopy; human; infant; intermethod comparison; male; nuclear magnetic resonance imaging; nuclear magnetic resonance scanner; pilot study; preoperative evaluation; priority journal; prospective study; urethra fistula; Anus, Imperforate; Female; Humans; Infant; Intestinal Mucosa; Magnetic Resonance Imaging; Male; Pilot Projects; Preoperative Care; Prognosis; Reproducibility of Results; Sensitivity and Specificity