Preoperative mapping of fistula-in-ano: a new three-dimensional MRI-based modelling technique

Colorectal Dis. 2013 Nov;15(11):e699-701. doi: 10.1111/codi.12438.

Abstract

Aim: We aimed to develop an intuitive, interactive, three-dimensional (3D) MRI modelling technique to produce a 3D image of fistula-in-ano.

Method: The 3D model was created from standard two-dimensional (2D) MRI sequences to produce an image that is anatomically correct. Individual muscle and soft-tissue layers were extracted from T1-weighted sequences and fistula pathology from short TI inversion recovery (STIR) sequences, to produce two separate volumes. These were then fused using postprocessing software (Vitrea Workstation version 6.3) to generate a 3D model.

Results: The final 3D model was incorporated into a PDF file that has an integrated computer aided design (CAD) viewer, allowing the surgeon to rotate it in any direction during preoperative planning or whilst in theatre.

Conclusion: As an adjunct to 2D MRI images and the associated radiology report, this model communicates the fistula anatomy to the clinician more clearly and should be particularly useful in complex cases.

Keywords: 3D; CAD; Fistula-in-ano; MRI; mapping; modelling.

Publication types

  • Video-Audio Media

MeSH terms

  • Computer Simulation
  • Computer-Aided Design
  • Humans
  • Imaging, Three-Dimensional / methods*
  • Magnetic Resonance Imaging*
  • Preoperative Period
  • Rectal Fistula / diagnosis*
  • Rectal Fistula / surgery*
  • Software