MAGNETIC-RESONANCE-IMAGING IN PERIANAL CR OHNS-DISEASE

Magnetic resonance imaging (MRI) was undertaken in a prospective study of 34 consecutive patients (21 women, 13 men; median age 31 [18-53] y ears) suspected of having active perianal Crohn's disease. The results of the investigation were compared with those obtained by independent observers on proctological and intraoperative examination (n = 31). A total of 58 fistulas and 21 abscesses were noted intraoperatively, 47 fistulas and all 21 abscesses by MRI, and 40 fistulas and 13 abscesse s proctologically. The proctological examination proved to be more sen sitive in demonstrating short subcutaneous or anovaginal fistulas (thr ee of four subcutaneous and two of five anovaginal fistulas were not s hown by MRI). Intersphincteric, ischiorectal and supralevator involvem ent was shown better by MRI. These results indicate that in perianal C rohn's disease MRI is a useful addition to proctological examination.