PMID- 32767809
OWN - NLM
STAT- MEDLINE
DCOM- 20210818
LR  - 20210818
IS  - 1463-1318 (Electronic)
IS  - 1462-8910 (Print)
IS  - 1462-8910 (Linking)
VI  - 23
IP  - 1
DP  - 2021 Jan
TI  - Magnetic resonance imaging after ligation of the intersphincteric fistula tract 
      for high perianal fistulas in Crohn's disease: a retrospective cohort study.
PG  - 169-177
LID - 10.1111/codi.15296 [doi]
AB  - AIM: Ligation of the intersphincteric fistula tract (LIFT) is increasingly being 
      used for surgical closure of high perianal fistulas in Crohn's disease. 
      Currently, data on postoperative MRI findings are scarce, although they are 
      considered important for assessing healing and recurrence. Our aim, therefore, 
      was to evaluate fistula characteristics on MRI and their relationship with 
      clinical outcomes after LIFT. METHOD: Consecutive Crohn's patients treated with 
      LIFT between 2007 and 2018 who underwent baseline and follow-up MRI were 
      retrospectively included. MRIs were scored by two radiologists according to 
      characteristics based on the original and modified Van Assche indices. MRI 
      findings, with emphasis on fibrosis, and the relationship with clinical healing, 
      re-interventions and recurrences are described. RESULTS: Twelve patients were 
      included [four men, median age 34 (interquartile range 28-39) years]. Follow-up 
      MRI was performed at a median of 5.5 months (interquartile range 2.5-6.0) after 
      LIFT. At baseline, all patients showed a tract with predominantly granulation 
      tissue, which changed to predominantly fibrotic in seven (in three of whom it was 
      completely fibrotic). All patients with a (predominantly) fibrotic tract had 
      clinical closure and no re-interventions or recurrences during long-term 
      follow-up. In contrast, of the five patients with persisting granulation tissue, 
      two reached clinical healing, two needed re-intervention and one had a 
      recurrence. CONCLUSION: Markedly decreased fistula activity can be observed on 
      MRI after LIFT. The majority of patients develop a predominantly fibrotic tract 
      relatively soon after LIFT without clinical recurrence, suggesting a highly 
      effective therapy. Unfavourable clinical outcomes were only present in patients 
      with persisting granulation tissue, indicating the potential prognostic value of 
      MRI.
CI  - (c) 2020 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on 
      behalf of Association of Coloproctology of Great Britain and Ireland.
FAU - Meima-van Praag, E M
AU  - Meima-van Praag EM
AUID- ORCID: 0000-0002-0932-228X
AD  - Department of Surgery, Amsterdam Gastroenterology, Endocrinology and Metabolism, 
      Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
FAU - van Rijn, K L
AU  - van Rijn KL
AUID- ORCID: 0000-0001-7937-5849
AD  - Department of Radiology and Nuclear Medicine, Amsterdam Gastroenterology, 
      Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, 
      The Netherlands.
FAU - Monraats, M A
AU  - Monraats MA
AD  - Department of Radiology and Nuclear Medicine, Amsterdam Gastroenterology, 
      Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, 
      The Netherlands.
FAU - Buskens, C J
AU  - Buskens CJ
AUID- ORCID: 0000-0001-9425-8683
AD  - Department of Surgery, Amsterdam Gastroenterology, Endocrinology and Metabolism, 
      Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
FAU - Stoker, J
AU  - Stoker J
AUID- ORCID: 0000-0002-9822-3784
AD  - Department of Radiology and Nuclear Medicine, Amsterdam Gastroenterology, 
      Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, 
      The Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20200829
PL  - England
TA  - Colorectal Dis
JT  - Colorectal disease : the official journal of the Association of Coloproctology of 
      Great Britain and Ireland
JID - 100883611
SB  - IM
MH  - Adult
MH  - Anal Canal
MH  - *Crohn Disease/complications/diagnostic imaging/surgery
MH  - Humans
MH  - Ligation
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - *Rectal Fistula/diagnostic imaging/etiology/surgery
MH  - Recurrence
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC7891352
OTO - NOTNLM
OT  - Perianal fistula
OT  - ligation of intersphincteric tract
OT  - magnetic resonance imaging
OT  - perianal Crohn's disease
COIS- EMMP, KLR, MAM and CJB have nothing to declare. JS has a research agreement with 
      Takeda not related to this topic.
EDAT- 2020/08/09 06:00
MHDA- 2021/08/19 06:00
PMCR- 2021/02/18
CRDT- 2020/08/09 06:00
PHST- 2020/05/18 00:00 [received]
PHST- 2020/07/28 00:00 [accepted]
PHST- 2020/08/09 06:00 [pubmed]
PHST- 2021/08/19 06:00 [medline]
PHST- 2020/08/09 06:00 [entrez]
PHST- 2021/02/18 00:00 [pmc-release]
AID - CODI15296 [pii]
AID - 10.1111/codi.15296 [doi]
PST - ppublish
SO  - Colorectal Dis. 2021 Jan;23(1):169-177. doi: 10.1111/codi.15296. Epub 2020 Aug 
      29.