Introducing 3D modelling of MRI in the preoperative mapping of perianal fistula: How it could help the surgeons?
Abstract Background Surgeons find treating perianal fistula difficult because insufficient drainage and failure to eradicate perianal sepsis could increase the risk of recurrence and postoperative complications. For better planning of the most suitable surgical technique, surgeons must consider the...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-03-01
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| Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43055-023-00989-z |
| _version_ | 1797865171028279296 |
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| author | Mary Salah Roman Boles Rania Farouk El-Sayed Haney Ahmed Sami Shawali Ahmed Farag Fawzy Salah Fawzy Maryse Youssef Awadallah |
| author_facet | Mary Salah Roman Boles Rania Farouk El-Sayed Haney Ahmed Sami Shawali Ahmed Farag Fawzy Salah Fawzy Maryse Youssef Awadallah |
| author_sort | Mary Salah Roman Boles |
| collection | DOAJ |
| description | Abstract Background Surgeons find treating perianal fistula difficult because insufficient drainage and failure to eradicate perianal sepsis could increase the risk of recurrence and postoperative complications. For better planning of the most suitable surgical technique, surgeons must consider the risk factors of recurrence with an accurate pre-operative assessment of perianal fistulae. The most common imaging method for grading primary perianal fistulas, identifying their complications, and locating occult extensions is magnetic resonance imaging (MRI). However, surgeons may find it challenging to read the lengthy reports of complex tracts, particularly for complicated patients. The creation of three-dimensional (3D) models has gained traction recently as a genuinely useful diagnostic tool for pre-operative planning. The authors evaluated the value of these surgical models. Inspecting the 3D models in addition to the routine two-dimensional study caused four out of five skilled colorectal surgeons to re-evaluate how far the fistulae extended. This made promise that 3D models would be helpful, simple to understand, and quick to interpret for colorectal surgeons. The purpose of the study is to assess the value of adding 3D modelling of MRI to standard two-dimensional MRI protocol for more accurate delineation of perianal fistula and its complications aiming at better surgical outcomes. Results Regarding 3D models, the highest degree of accuracy was in detecting supra-levator extension (100%) by both the third radiologist and the surgeon. There was a statistically high diagnostic inter-observer agreement between both, with a p-value < 0.0001. The highest inter-observer agreement was in the supra-levator extension (50/50, 100%), and the lowest agreement was in the side branches detection (44/50, 88%). Conclusions Pre-operative 3D MRI modelling provided the surgeon with a pre- and intra-operative road map that improved the surgeon’s orientation and ability to see complex perianal fistulas and their consequences, especially those with supra levator extension, thus helping the surgeon achieve better surgical results and decrease the preoperative risk factors of recurrence. Surgeons should utilise it in complex and recurrent cases reducing preoperative risk factors and improving outcomes. Although this technique is expensive, its cost–benefit ratio is low relative to recurrent hospitalisation and complications. |
| first_indexed | 2024-04-09T23:04:51Z |
| format | Article |
| id | doaj.art-16040beecb3b408ab74388a4e165ad06 |
| institution | Directory Open Access Journal |
| issn | 2090-4762 |
| language | English |
| last_indexed | 2024-04-09T23:04:51Z |
| publishDate | 2023-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Radiology and Nuclear Medicine |
| spelling | doaj.art-16040beecb3b408ab74388a4e165ad062023-03-22T10:45:42ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622023-03-0154111210.1186/s43055-023-00989-zIntroducing 3D modelling of MRI in the preoperative mapping of perianal fistula: How it could help the surgeons?Mary Salah Roman Boles0Rania Farouk El-Sayed1Haney Ahmed Sami Shawali2Ahmed Farag3Fawzy Salah Fawzy4Maryse Youssef Awadallah5Department of Diagnostic and Interventional Radiology, Kasr Al Ainy Hospital, Faculty of Medicine, Cairo UniversityDepartment of Diagnostic and Interventional Radiology, Kasr Al Ainy Hospital, Faculty of Medicine, Cairo UniversityDepartment of Diagnostic and Interventional Radiology, Kasr Al Ainy Hospital, Faculty of Medicine, Cairo UniversityDepartment of General Surgery, Kasr Al Ainy Hospital, Faculty of Medicine, Cairo UniversityDepartment of General Surgery, Faculty of Medicine, Ain Shams UniversityDepartment of Diagnostic and Interventional Radiology, Kasr Al Ainy Hospital, Faculty of Medicine, Cairo UniversityAbstract Background Surgeons find treating perianal fistula difficult because insufficient drainage and failure to eradicate perianal sepsis could increase the risk of recurrence and postoperative complications. For better planning of the most suitable surgical technique, surgeons must consider the risk factors of recurrence with an accurate pre-operative assessment of perianal fistulae. The most common imaging method for grading primary perianal fistulas, identifying their complications, and locating occult extensions is magnetic resonance imaging (MRI). However, surgeons may find it challenging to read the lengthy reports of complex tracts, particularly for complicated patients. The creation of three-dimensional (3D) models has gained traction recently as a genuinely useful diagnostic tool for pre-operative planning. The authors evaluated the value of these surgical models. Inspecting the 3D models in addition to the routine two-dimensional study caused four out of five skilled colorectal surgeons to re-evaluate how far the fistulae extended. This made promise that 3D models would be helpful, simple to understand, and quick to interpret for colorectal surgeons. The purpose of the study is to assess the value of adding 3D modelling of MRI to standard two-dimensional MRI protocol for more accurate delineation of perianal fistula and its complications aiming at better surgical outcomes. Results Regarding 3D models, the highest degree of accuracy was in detecting supra-levator extension (100%) by both the third radiologist and the surgeon. There was a statistically high diagnostic inter-observer agreement between both, with a p-value < 0.0001. The highest inter-observer agreement was in the supra-levator extension (50/50, 100%), and the lowest agreement was in the side branches detection (44/50, 88%). Conclusions Pre-operative 3D MRI modelling provided the surgeon with a pre- and intra-operative road map that improved the surgeon’s orientation and ability to see complex perianal fistulas and their consequences, especially those with supra levator extension, thus helping the surgeon achieve better surgical results and decrease the preoperative risk factors of recurrence. Surgeons should utilise it in complex and recurrent cases reducing preoperative risk factors and improving outcomes. Although this technique is expensive, its cost–benefit ratio is low relative to recurrent hospitalisation and complications.https://doi.org/10.1186/s43055-023-00989-zColorectal surgeryRectal fistula3D imagingsComputer generated |
| spellingShingle | Mary Salah Roman Boles Rania Farouk El-Sayed Haney Ahmed Sami Shawali Ahmed Farag Fawzy Salah Fawzy Maryse Youssef Awadallah Introducing 3D modelling of MRI in the preoperative mapping of perianal fistula: How it could help the surgeons? The Egyptian Journal of Radiology and Nuclear Medicine Colorectal surgery Rectal fistula 3D imagings Computer generated |
| title | Introducing 3D modelling of MRI in the preoperative mapping of perianal fistula: How it could help the surgeons? |
| title_full | Introducing 3D modelling of MRI in the preoperative mapping of perianal fistula: How it could help the surgeons? |
| title_fullStr | Introducing 3D modelling of MRI in the preoperative mapping of perianal fistula: How it could help the surgeons? |
| title_full_unstemmed | Introducing 3D modelling of MRI in the preoperative mapping of perianal fistula: How it could help the surgeons? |
| title_short | Introducing 3D modelling of MRI in the preoperative mapping of perianal fistula: How it could help the surgeons? |
| title_sort | introducing 3d modelling of mri in the preoperative mapping of perianal fistula how it could help the surgeons |
| topic | Colorectal surgery Rectal fistula 3D imagings Computer generated |
| url | https://doi.org/10.1186/s43055-023-00989-z |
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