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MRI of Fistula In Ano: Inter- and Intraobserver Agreement and Effects of Directed Education

Gordon N. Buchanan1, Steve Halligan2, Stuart Taylor2, Andrew Williams1, Richard Cohen1 and Clive Bartram2

1 Department of Surgery, St. Marks Hospital, Intestinal Imaging, Middlesex, England.
2 Intestinal Imaging Centre, St. Marks Hospital, Level 4V, Watford Rd., Harrow, Middlesex, England HA1 3UJ.



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  		Fig. 1. —Axial STIR MR image obtained at mid anal canal level in 41-year-old man in whom expert observer correctly identified intershpincteric fistula in ano (arrow). Location was misclassified as transsphincteric by novice before directed education.

 


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  		Fig. 2. —Axial STIR MR image obtained at mid anal canal level in 36-year-old woman in whom both expert and novice observers correctly identified transsphincteric fistula in ano associated with ischiorectal extension (arrow) after period of directed education.

 

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