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Fig. 6 | Egyptian Journal of Radiology and Nuclear Medicine

Fig. 6

From: Magnetic resonance imaging in the workup of patients with perianal fistulas

Fig. 6

A 58-year-old male patient who complained of left perianal discharge. MRI in the form of multiple pulse sequences revealed in axial T2W images (A–D): A External cutaneous opening of the fistulous tract in the left perianal region (white arrow). B Fistulous tract at the left ischioanal fossa (red arrow). C The fistulous tract passed through the external sphincter (yellow arrow). D Internal mucosal opening at six o’clock (blue arrow). DWI showed (E, F): hyper-intense signal of the fistulous tract. ADC images (G, H) showed: a hypo-intense signal of the fistulous tract denoting restriction. The final diagnosis was a left, grade III, trans-sphincteric fistula

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