{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:27:06Z","timestamp":1783517226275,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Perianal fistulae are sequelae of suppurative anal disease. Preoperative imaging provides a detailed evaluation of fistula anatomy and anal sphincter involvement. This helps in determining surgical approach and prevents complications such as recurrence and incontinence. Three\u2010dimensional endoanal ultrasonography (3D\u2010EAUS) has emerged as a novel technique in fistula imaging in recent times. The aim of this study was to evaluate the diagnostic utility of 3D\u2010EAUS in perianal fistulae by identifying the preoperative imaging characteristics and their comparison with intraoperative findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>This research employed a retrospective observational study design. It was a diagnostic validation study wherein 3D\u2010EAUS imaging features were compared with the intraoperative surgical findings (considered as the reference standard for analysis). Medical records of patients operated for perianal fistulae over a period of 24\u2009months from June 2023 to May 2025 were accessed from the medical records department. All the patients who underwent 3D\u2010EAUS as part of the preoperative workup for fistula surgery were included in the study, subject to the completeness of records and availability of adequate preoperative imaging. Based on the eligibility criteria, 345 patients were selected as the study population. Demographic characteristics, ultrasonography features, and intraoperative findings were recorded. Diagnostic indices were calculated for various parameters of 3D\u2010EAUS, followed by a comparison of 3D\u2010EAUS features with the intraoperative findings using concordance metrics and kappa statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Demographic analysis revealed the mean age of study population was 48.9\u2009years with a standard deviation of +\/\u221210.7\u2009years. There was an obvious male preponderance with 76% males as compared to 24% females. The study revealed that trans\u2010sphincteric fistula was the most common type (57.4%) while posterior (5\u20137 o'clock) was the commonest position for internal opening (54.4%). 3D\u2010EAUS showed a high sensitivity (&gt;\u200985%), specificity (&gt;\u200995%) and diagnostic accuracy (&gt;\u200990%) for various parameters in the diagnosis of perianal fistulae. Concordance statistics indicated 88.7% concordance with intraoperative findings for primary tract identification while 95.1% patients correlated for internal opening identification. Secondary tracts were accurately delineated in 84.6% patients while 92.3% showed concordance for adjacent abscesses\/collections. Kappa values suggested almost perfect agreement between 3D\u2010EAUS and surgical findings for internal opening (\n                      <jats:italic>k<\/jats:italic>\n                      \u2009=\u20090.91) and adjacent abscess identification (\n                      <jats:italic>k<\/jats:italic>\n                      \u2009=\u20090.84) while primary and secondary tract identification showed significant agreement (\n                      <jats:italic>k<\/jats:italic>\n                      \u2009=\u20090.77 and\n                      <jats:italic>k<\/jats:italic>\n                      \u2009=\u20090.68 respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Comprehensive preoperative imaging of perianal fistulae ensures proper management and prevents complications. 3D\u2010EAUS shows high sensitivity, specificity, and accuracy in the diagnosis of perianal fistulae. It overcomes the imaging limitations of 2D ultrasonography and has a diagnostic efficacy comparable to MRI fistulogram, although at a much lower cost. This makes 3D\u2010EAUS a suitable alternative to MRI in preoperative imaging as well as in follow\u2010up cases, especially in resource\u2010poor settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcu.70296","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:05:15Z","timestamp":1783515915000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Role of\n                    <scp>3D<\/scp>\n                    Endoanal Ultrasonography (\n                    <scp>3D<\/scp>\n                    \u2010\n                    <scp>EAUS<\/scp>\n                    ) in the Evaluation of Perianal Fistulae\u2014A Retrospective Observational Study at a Tertiary Care Centre"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8510-7359","authenticated-orcid":false,"given":"Manohar B.","family":"Kachare","sequence":"first","affiliation":[{"name":"Department of Radiodiagnosis Government Medical College  Miraj Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7920-7324","authenticated-orcid":false,"given":"Zaid P.","family":"Inamdar","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis Government Medical College  Miraj Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay B.","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Department of Surgery Vishrambag Hospital  Sangli Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"e_1_2_14_2_1","first-page":"19","article-title":"Anatomy of the Pelvic Floor and Anal Sphincters","volume":"25","author":"Agarwal S.","year":"2025","journal-title":"JIMSA"},{"issue":"2","key":"e_1_2_14_3_1","first-page":"289","article-title":"Comparison Between the Accuracy of Endoanal Ultrasonography and Body Coil MRI in Preoperative Assessment of Internal Opening of Perianal Fistula Complex","volume":"83","author":"Ahmed F. A.","year":"2015","journal-title":"Medical Journal of Cairo University"},{"issue":"1","key":"e_1_2_14_4_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13104-019-4098-2","article-title":"Value of Three Dimensional Endoanal Ultrasound Scan (3D EAUS) in Preoperative Assessment of Fistula in Ano","volume":"12","author":"Almeida I. S.","year":"2019","journal-title":"BMC Research Notes"},{"issue":"4","key":"e_1_2_14_5_1","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1007\/s00384-015-2167-0","article-title":"Role of Tridimensional Endoanal Ultrasound (3D EAUS) in the Preoperative Assessment of Perianal Sepsis","volume":"30","author":"Brillantino A.","year":"2015","journal-title":"International Journal of Colorectal Disease"},{"issue":"5","key":"e_1_2_14_6_1","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s11547-018-0975-3","article-title":"Preoperative Assessment of Simple and Complex Anorectal Fistulas: Tridimensional Endoanal Ultrasound? 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