THE MR APPEARANCE OF VAGINAL FISTULAS

OBJECTIVE. The aim of this study was to determine the accuracy of MR i maging in revealing complex vaginal fistulas. SUBJECTS AND METHODS. Fi fteen patients with clinical symptoms of vaginal fistulas were examine d with MR imaging, using a combination of T1-weighted, T2-weighted, an d fast multiplanar inversion recovery sequences in the axial plane, al ong with T2-weighted and fast multiplanar inversion recovery sequences in the sagittal plane. Observers examined the scans for a fistula and any associated masses or collections. The MR findings were recorded w ith the observers unaware of the results of cystoscopy and sigmoidosco py under anesthesia. The MR findings were correlated with examination under anesthesia. RESULTS. Vaginal fistulas were seen in ten patients. All fistulas were confirmed surgically. Of the five patients with no fistulas revealed on MR imaging, examination under anesthesia also rev ealed no fistulas in four. However, in the fifth patient, examination under anesthesia revealed an epithelialized track, which was not seen on MR imaging. CONCLUSION. MR imaging was accurate in revealing and de lineating the extent of vaginal fistulas in patients with clinical sym ptoms of such fistulas.