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Review
. 2025 May;63(3):447-463.
doi: 10.1016/j.rcl.2024.10.003. Epub 2025 Jan 8.

MR Imaging of Perianal Fistulas: A Review of Fundamentals, Complications, and Post-Therapy Imaging

David J Bartlett  1 , Avinash K Nehra  1 , Joel G Fletcher  1 , Eric C Ehman  2
Affiliations
Review

MR Imaging of Perianal Fistulas: A Review of Fundamentals, Complications, and Post-Therapy Imaging

David J Bartlett et al. Radiol Clin North Am. 2025 May.

Abstract

MR imaging is the gold standard for diagnosis, providing detailed evaluation of perianal fistulas. MR imaging aids in detecting, classifying, and monitoring fistulas and guiding treatment. Detailed radiology reports, incorporating patient history and disease-specific considerations, are essential for effective management and improved clinical outcomes. This review overviews fundamental high-yield concepts to aid radiologists in interpreting MR imaging for perianal fistulas with multiple case examples.

Keywords: Crohn’s disease; Fistula; MR imaging; Perianal.

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Conflict of interest statement

Disclosure J.G. Fletcher reports grants to his institution from The Leona M. and Harry B. Helmsley Charitable Trust, United States, Siemens Healthineers, Germany, Alimentiv, and Pfizer, United States; consulting with funds to institution from Genentech, Boehringer Ingelheim, Glaxo Smith Kline, Janssen, Medtronic, Takeda, Alimentiv, Inc Red X Pharma, and collaboration (coinvestigator) with Motilent. The other authors have nothing to disclose.

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