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Fig. 7 | Egyptian Journal of Radiology and Nuclear Medicine

Fig. 7

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

Fig. 7

A 35-year-old female patient presented with left perianal discharge. She was diagnosed clinically with a perianal abscess. Therefore, from the start, we injected IV contrast material. MRI examination after IV contrast injection revealed in enhanced axial T1 FATSAT images (A–D): A External cutaneous opening of the fistulous tract in the left perianal region (white arrow). B Distended cavity with peripheral enhancement at the left ischioanal fossa denoting abscess formation (red arrow). C An abscess ascending upward and piercing the left levator ani muscle with supralevator extension (yellow arrow). D Internal mucosal opening at the anorectal junction at four o'clock (green arrow). E Enhanced coronal T1 FATSAT image shows the course of the left extrasphincteric fistula (blue arrow). The final diagnosis was a left, grade V, extrasphincteric fistula

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