JMIR Publications

ABSTRACT

Background:

Perianal abscesses are common anorectal conditions that often necessitate surgical intervention. Accurate preoperative assessment is crucial for effective treatment and reducing recurrence rates. Diffusion tensor imaging (DTI) is a valuable method for visualizing the degree of infection and infiltration, the extent of abscess formation, and the relationship between perianal abscess erosion. However, there is currently a lack of specific studies focusing on perianal abscesses.

Objective:

The objective of this study was to investigate the diagnostic utility of DTI in the preoperative assessment of perianal abscesses. By enhancing the precision of preoperative evaluation, we aimed to minimize damage to the anal sphincter, reduce the recurrence rate, and improve the prognosis and quality of life for patients.

Methods:

A randomized, prospective, single-blind (patient) clinical trial was conducted. Ninety participants were randomized into two groups—a DTI group and a conventional MRI group. A structured report was completed based on the imaging of the perirectal abscesses in terms of their location, number, specific pus cavity alignment, thickness, and relationship to the surrounding muscles (sphincter, anal retentive muscle). Additionally, the patient's condition was assessed, and corresponding surgical treatment was performed. If the patient's blood routine showed infection, cefuroxime sodium combined with metronidazole was given intravenously as an anti-infective. Postoperatively, the primary variable was assessed for recurrence rate at 6 months, and the secondary variables included postoperative pain scores on days 3 and 7, peripheral blood inflammatory factors, and assessment of anal function.

Results:

This trial has not yet been conducted, so no results related to the comparison between the DTI group and the conventional MRI group (such as 6-month recurrence rate, postoperative pain scores, changes in peripheral blood inflammatory factors, and differences in anal function) are available. Data collection and statistical analysis will be carried out after the trial is completed, following the pre-designed statistical plan.

Conclusions:

We believe that the DTI technique can be used to gain a deeper understanding of the relationship between the internal orifice, the degree of infected infiltration, the extent of the abscess, and the involvement of the tissues and muscles surrounding the anorectum in patients with perianal abscess. Deep pelvic floor DTI reveals the complex three-dimensional structure of the pelvic floor in perianal abscesses through structured reports, which may provide new insights into the diagnosis of perianal abscesses. Clinical Trial: ITMCTR2025000068