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Fig. 4 | Egyptian Journal of Radiology and Nuclear Medicine

Fig. 4

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

Fig. 4

A 50-year-old male patient presented with a high perianal fistula and came for a follow-up. 2D MRI with oblique axial T2 (TR/TE, 7228/100) (a) and sagittal T2W images (b) shows a tract starting at the right scrotal sac (blue arrow) extending posteriorly to breech the proximal third of deep external anal sphincter, with an internal opening at 12 o’clock (black arrow). MRI reveals a small side branch from the under-surface of the tract (white arrow in b). Lithotomy view (c) and side view (d) of the 3D model show the right scrotal opening (blue arrow), the tract (red) crossing from anterior to posterior, breaching both internal and external anal sphincters at 12 o’clock (black arrow). The radiologist or the surgeon did not identify the fore-mentioned side branch (white arrow)

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