CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2017; 27(04): 482-487
DOI: 10.4103/ijri.IJRI_417_16
Abdomen

Role of transperineal ultrasound in infective and inflammatory disorders

Chaitanya I Puranik
Department of Radio-diagnoses, Vishesh Hospital and Diagnostic Center, A.B. Road, Near Geeta Bhawan Chouraha, INDORE, Madhya Pradesh, India
,
Vinod J Wadhwani
Department of Radio-diagnoses, Vishesh Hospital and Diagnostic Center, A.B. Road, Near Geeta Bhawan Chouraha, INDORE, Madhya Pradesh, India
,
Deep M Vora
Department of Radio-diagnoses, Vishesh Hospital and Diagnostic Center, A.B. Road, Near Geeta Bhawan Chouraha, INDORE, Madhya Pradesh, India
› Author Affiliations
Financial support and sponsorship Nil.

Abstract

Aims: To evaluate the role of transperineal ultrasound as screening tool in infective and inflammatory diseases of perianal region. Materials and Methods: Initially, clinical examination of the perineal region of patients (pts) for perianal external opening of tracts, swelling and tenderness is done. The perineal USG was performed using 2 -5 MHz sector probe and 7 -13 MHz linear probe on GE logiq P 5 ultrasound machine. Internal opening of any fistulous tract were described with clockwise position and tracts were traced upto their external opening and perifocal area were screened for any ramification. The Park et al. classification was used for classifying the tracts. Results: Out of 492 pts, 60 pts were normal, 257 pts had fistula, 114 pts had sinuses, 44 pts had only abscess without fistula or sinus and 17 pts had other pathologies with 95% sensitivity (Sn), 100% specificity (Sp) and Positive Predictive Value (PPV) and 95% Negative Predictive Value (NPV) for fistula and 94% Sn, 97% Sp, 89% PPV and 98% NPV for active sinuses and 98% Sp, 96% ppv and 100% NPV and Sn for abscesses. Conclusions: Transperineal Ultrasound should be performed as first line imaging modality for suspicion of low perianal fistula with high sensitivity, specificity, and negative predictive value at much lower cost and less time as compared to perineal MRI.



Publication History

Article published online:
27 July 2021

© 2017. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Barleben A, Mills S. Anorectal anatomy and physiology. Surg Clin North Am 2010;90:1-15.
  • 2 Szurowska E, Wypych J, Izycka-Swieszewska E. Perianal fistulas in Crohn's disease: MRI diagnosis and surgical planning. Abdom Imaging 2007;32:705-18.
  • 3 Rickard MJ. Anal abscesses and fistulas. ANZ J Surg 2005;75:64-72.
  • 4 O'Malley RB, Al-Hawary MM, Kaza RK, Wasnik AP, Liu PS, Hussain HK. Rectal imaging: Part 2, Perianal fistula evaluation on pelvic MRI–What the radiologist needs to know. AJR Am J Roentgenol 2012;199:W43-53.
  • 5 Parks AG, Gordon PH, Hardcastle JD. A classification of fistula-in-ano. Br J Surg 1976;63:1-12.
  • 6 Domkundwar SV, Shinagare AB. Role of transcutaneous perianal ultrasonography in evaluation of fistulas in ano. J Ultrasound Med 2007;26:29-36.
  • 7 Marks CG, Ritchie JK. Anal fistulas at St Mark's Hospital. Br J Surg 1977;64:84-91.