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Fig. 3 | Egyptian Journal of Radiology and Nuclear Medicine

Fig. 3

From: Introducing 3D modelling of MRI in the preoperative mapping of perianal fistula: How it could help the surgeons?

Fig. 3

A 54-year-old male patient presented with discharging perianal fistula. On DRE, a left high posterior tract is felt. 2D MRI in oblique coronal T2 (TR/TE, 3259/100) (a), oblique axial T2W images (TR/TE, 7228/100) (b, c) show a left posterior perianal tract extending along the left ischio-anal fossa to breech the left sling of puborectalis muscle at 5 o’clock (white arrows) (b), to end at the anal canal at 6 o’clock (white arrow) (c). Posterior coronal view (d) and top views (e, f) of the 3D model show a posterior left high tract, breeching the puborectalis muscle (white arrow). The internal opening was not seen by either the radiologist or the surgeon due to the overlap of structures. Retrograde, on applying the wireframe option, the site of the internal opening was identified (white arrow) (f)

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