{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:23:18Z","timestamp":1787768598193,"version":"build-2784847793"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Perianal itching is a common complaint associated with a variety of anorectal conditions such as fistulas, abscesses, hemorrhoids and pilonidal disease. Accurate diagnosis is essential for effective treatment and magnetic resonance imaging (MRI) plays a pivotal role due to its excellent soft-tissue resolution and multiplanar imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The objective of this study was to evaluate the diagnostic utility of MRI in patients with perianal itching, focusing on the identification and classification of perianal fistulas and their mimics, using St. James and Parks classification systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This prospective observational study was conducted in the department of radiodiagnosis over 6 months (December 2023\u2013May 2024) and included 59 patients aged \u2265 18 years with perianal itching. MRI (1.5T) pelvis scans were obtained using T1, T2, short tau inversion recovery, diffusion-weighted imaging, apparent diffusion coefficient and postcontrast sequences. Fistulas were classified using the St. James and Parks systems. Chi-square test assessed the correlation between the classifications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 59 cases, perianal fistula was most common (57.6%), followed by abscess (33.9%), pilonidal sinus (5.1%) and hemorrhoids (3.4%). The mean age was 45.8 \u00b1 10.6 years with male predominance. Grade 2 fistulas ( 47.06%) and intersphincteric type (64.70%) were most frequent. A strong correlation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) was observed between St. James and Parks classifications. Common complications included abscesses (70.6%) and horseshoe tracts (14.7%). MRI findings showed high concordance with clinical and surgical data.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>MRI is a sensitive, noninvasive tool for evaluating perianal itching. It effectively characterizes underlying pathology, guides treatment planning, shows strong classification correlation and enhancing clinical decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aam.aam_258_25","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T17:00:44Z","timestamp":1757955644000},"page":"840-846","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Unraveling the Causes of Perianal Itching: Magnetic Resonance Imaging as a Diagnostic Tool for Perianal Fistulas and Its Mimics"],"prefix":"10.4103","volume":"25","author":[{"given":"Sanket Vinubhai","family":"Davra","sequence":"first","affiliation":[{"name":"Department of Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anurag","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Fortis Hospital, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anushka","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Fortis Hospital, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yawar Ali","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"R1-20260803","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s13017-021-00384-x","article-title":"Anorectal emergencies: WSES-AAST guidelines","volume":"16","author":"Tarasconi","year":"2021","journal-title":"World J Emerg Surg"},{"key":"R3-20260803","doi-asserted-by":"crossref","first-page":"466","DOI":"10.3390\/jcm12020466","article-title":"Crohn's disease-associated and cryptoglandular fistulas: Differences and similarities","volume":"12","author":"Zhou","year":"2023","journal-title":"J Clin Med"},{"key":"R4-20260803","doi-asserted-by":"crossref","first-page":"3272","DOI":"10.3748\/wjg.v17.i28.3272","article-title":"Anal fistula: Intraoperative difficulties and unexpected findings","volume":"17","author":"Abou-Zeid","year":"2011","journal-title":"World J 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Surg"},{"key":"R8-20260803","doi-asserted-by":"crossref","first-page":"712","DOI":"10.3348\/kjr.2014.15.6.712","article-title":"Imaging of anal fistulas: Comparison of computed tomographic fistulography and magnetic resonance imaging","volume":"15","author":"Liang","year":"2014","journal-title":"Korean J Radiol"},{"key":"R9-20260803","first-page":"133","article-title":"Preoperative MRI of perianal fistula: Is it really indispensable?Can it be deceptive?","volume":"49","author":"Agha","year":"2013","journal-title":"Alex J Med"},{"key":"R10-20260803","doi-asserted-by":"crossref","first-page":"84","DOI":"10.33545\/26644436.2020.v3.i1b.59","article-title":"Spectrum of MRI imaging features in perianal discharge","volume":"3","author":"Chail","year":"2020","journal-title":"Int J Radiol Diagn Imaging"},{"key":"R11-20260803","doi-asserted-by":"crossref","first-page":"140","DOI":"10.3126\/ajms.v12i12.39695","article-title":"Role of magnetic resonance imaging in diagnosis and grading of perianal fistulas","volume":"12","author":"Kakani","year":"2021","journal-title":"Asian J Med Sci"},{"key":"R12-20260803","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1097\/DCR.0000000000001038","article-title":"Closing perianal fistulas using a laser: Long-term results in 103 patients","volume":"61","author":"Terzi","year":"2018","journal-title":"Dis Colon Rectum"},{"key":"R13-20260803","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/j.ejrnm.2013.09.003","article-title":"Magnetic resonance imaging evaluation of perianal fistula","volume":"44","author":"Daabis","year":"2013","journal-title":"Egypt J Radiol Nucl Med"},{"key":"R14-20260803","first-page":"3674","article-title":"Precise and comprehensive evaluation of perianal fistulas, classification and related complications using magnetic resonance imaging","volume":"15","author":"Zhao","year":"2023","journal-title":"Am J Transl 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