POST CONTRAST
- T1 FSE Fat Sat Axial 5mm with intervel .5mm
OPTIONAL SEQUENCES
- STIR Axial/Coronal
- 3D Dynamic Post contrast
- T2-weighted SE with saline instillation (MR fistulography)
TECHNICAL NOTES:
- Mucin-containing fistulas were recognized as tubular structures with a hyperintense signal surrounded by a hypointense rim on T2-weighted two-dimensional turbo SE images. Non–mucin-containing fistulas were recognized as tubular structures with a hypointense signal on T2-weighted images. Fluid-filled cavities were hyperintense on T2-weighted images and surrounded by a border of hypointense signal.
- Dynamic gadolinium-enhanced imaging has been described as superior to STIR for detecting active sepsis, with the main advantage of being faster but with the additional cost of gadolinium use. MR fistulography with instillation of saline can facilitate the detection of fistula tracks, but the technique is cumbersome and depends on the existence of an external opening
- MR imaging with an endoanal coil can also generate images with a high spatial resolution because of the very high signal-to-noise ratio near the coil. The main drawback of the endoanal MR imaging technique is that it fails to show many secondary extensions that lie beyond the range of the and this problem can be overcome by combining the endoanal coil with a phased-array coil.
- Spasmolytics such as 20 mg of hyoscine butylbromide (Buscopan; Boehringer Ingelheim, Ingelheim, Germany) or 1 mg of glucagon administered intramuscularly may help to reduce motion-induced artifacts. (Hyoscine butylbromide is not licensed for use in the United States.)
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