Abstract
Perianal fistula is a tunnel-shaped formation extending from the last part of the colon to the skin surrounding the anus which develops following the infection of the mucous glands.
In this article, our aim was to present the images of two cases in which perianal fistulas were detected incidentally during 18-fluorine-2-deoxyglucose-positron emission tomography / computed tomography (18 F- FDG PET/CT) scanning process. These patients have a history of primary malignancy and they were scanned primarily to determine the staging and treatment procedure. The first patient was a 57-year-old woman diagnosed with Hodgkin lymphoma and she was scanned by 18 F- FDG PET/CT imaging to determine the staging and treatment procedure.The second patient was a 70-year-old man diagnosed with sigmoid colon cancer and he was scanned by 18 F- FDG PET/CT imaging to determine the staging and treatment procedure. In 18 F- FDG PET/CT scanning, fistula tracts anastomosed to the skin were observed in both patients in the left perianal regions and in these locations, pathological increased 18 F-FDG uptake was seen. Although 18 F- FDG is a radionuclide generally used for evaluating the malignant diseases, this agent’s uptake was also seen in benign infections and inflammatory lesions which are not malignant.18 F FDG PET/BT is a non-invasive diagnostic method which provides information concerning the metabolic activity of the lesion and its location.
Keywords
References
- 1. Halligan S et al. Imaging of Fistula in Ano,Radiology: 2006; 239(1): 18-33.
- 2. Obuz F. Anorektal bölgenin değerlendirilmesinde MRG.Türkiye Klinikleri Radyoloji özel Dergisi, 2008;1(2):131-141.
- 3. Parks AG, Gordon PH,Handcastle JD.A Classification of fistula in-ano. BrJ.Surg.1976;63:1-12.
- 4. Cook GJ,Maisey MN,Fogelman I. Normal variants, artefacts and interpretative pitfalls in PET imaging with 18-FDG and C-11 methioinine. Eur J.NucI Med 1999;26:1363-1378.
- 5. Zhuang H,Alavi A. 18FDG PET imaging in the detection and monitoring of infection and inflammation. Semin Nucl Med 2002;32:47-59.
- 6. Fantone JC.Ward PA.Role of oxygenderived free radicals and metabolites in leukocyte-dependent inflammatory reactions. Am J Pathol 1982; 107:395-418.
- 7. Weisdorf DJ, Craddock PR, Jacob HS.GIycogenolysisversus glucose transport in human granulocytes: dif-ferantial activation in phagocytosis and chemotaxis.Blood 1982;60:888-893.
- 8. Kubotar R,Yamada S,Kubota K,et al.lntratumoral distribution of fluorine-18-fluorodeoxyglucose in vivo:high accumulation in macrophages and granulation tissues studies by microautoradiography J Nucl Med 1992;33:1972-1980.
- 9. Love C, et al. FDG PET of infection and inflammation. J Nucl Med.2005; 25: 1357-1368.
- 10. Hutan M, Satko M, Dimov A. Significance of MRI in the treatment of perianal fistula. Bratisil Lek Listy 2009;110(3):162-5.
- 11. Joyce M.Veniero JC, Magnetic resonance imaging in the management of anal fistula and anorectal sepsis. Clinical Colon Rectal Surgery 2008;21(3):213-9.
- 12. Morris J, Spencer JA, Ambrose NS. MR imaging classification of perianal fistulas and its implications for patient management. Radiographics. 2000;20(3):623-35.
- 13. Spencer JA,Chapple K, Wilson D et all. Outcome after surgery for perianal fistula: predictive value of MR imaging. AJR Am J Roentgenol. 1998;171(2):403-6.
- 14. Wahl RL. PET ve PET/BT prensipler ve uygulamalar: İnfeksiyon ve inflamasy-onun PET/BT ile görüntülenmesi. İkinci baskı. 2011; 12: 619-620.
- 15. Eugene C.Lin-Abass Alavi. PET and PET/CT A Clinical Guide 2nd edition. 2009:245.
- 16. Pellegrino D,et al. Inflammation and infection: Imaging properties of 18 F FDG PET/CT-labeled white blood cells versus 18 F FDG. J Nucl Med 2005; 46:1522-1530.
- 17. Tatlıdil R.Jadvar H.Incidental colonic FDG uptake: Corelation with colon-oskopic and histopathologic findings. Radiology 2002; 224:783-787.
- 18. Ehab M.Kamel et al. Significance of Incidental 18 F FDG Accumulations in the Gastrointestinal Tract in PET/ CT Correlation with Endoscopic and Histopathologic Results. J Nucl. Med 2004;45:1804-1810.
- 19. Zhuang H, et al.Applications of fluode-oxyglucose-PET imaging in the detection of infection and inflammation and other benign disorders. Radiol Clin N Am 2005;43:121-134.
Abstract
Perianal fistül, bir ucu makat çevresindeki cilde diğer ucu kalın barsağın son kısmına doğru uzanan tünel şeklindeki bir yapı olup anal kanaldaki mukus bezlerinin enfeksiyonu sonucu gelişir.Bu makalede primer malignitesi bulunan, evrelendirme ve tedavi planlaması amacıyla F -18 florodeoksiglukoz (F-18 FDG) Pozitron emisyon tomografisi /Bilgisayarlı tomografi (PET/BT) taramasında rastlantısal olarak perianal fistül tespit edilen iki vakanın görüntülerini sunmayı amaçladık.İlk olgumuz 57 yaşında Hodgkin lenfoma tamlı, evreleme ve tedavi planlanması amacıyla F-18 FDG PET/BT taraması yapılan bayan hasta idi.İkinci olgumuz ise 70 yaşında sigmoid kolon kanseri tamlı, evreleme ve tedavi planlanması amacıyla F-18 FDG PET/BT taraması yapılan erkek hasta idi. F-18 FDG PET/BT taramasında; her iki hastada sol perianal bölgede cilde ağızlaşan fistül traktı izlenmiş olup bu lokalizasyonda patolojik artmış F-18 FDG tutulumu izlendi. F-18 FDG, malign hastalıkların değerlendirilmesinde yaygın olarak kullanılan bir radyonüklid olmasına karşın malign olmayan benign enfeksiyon ve enflamatuar lezyonlarda da tutulan bir ajandır. F-18 FDG PET/BT, lezyonun metabolik aktivitesinin yanı sıra, anatomik lokalizasyonu hakkında da bilgi veren non-invaziv bir tanı yöntemidir.
Keywords
References
- 1. Halligan S et al. Imaging of Fistula in Ano,Radiology: 2006; 239(1): 18-33.
- 2. Obuz F. Anorektal bölgenin değerlendirilmesinde MRG.Türkiye Klinikleri Radyoloji özel Dergisi, 2008;1(2):131-141.
- 3. Parks AG, Gordon PH,Handcastle JD.A Classification of fistula in-ano. BrJ.Surg.1976;63:1-12.
- 4. Cook GJ,Maisey MN,Fogelman I. Normal variants, artefacts and interpretative pitfalls in PET imaging with 18-FDG and C-11 methioinine. Eur J.NucI Med 1999;26:1363-1378.
- 5. Zhuang H,Alavi A. 18FDG PET imaging in the detection and monitoring of infection and inflammation. Semin Nucl Med 2002;32:47-59.
- 6. Fantone JC.Ward PA.Role of oxygenderived free radicals and metabolites in leukocyte-dependent inflammatory reactions. Am J Pathol 1982; 107:395-418.
- 7. Weisdorf DJ, Craddock PR, Jacob HS.GIycogenolysisversus glucose transport in human granulocytes: dif-ferantial activation in phagocytosis and chemotaxis.Blood 1982;60:888-893.
- 8. Kubotar R,Yamada S,Kubota K,et al.lntratumoral distribution of fluorine-18-fluorodeoxyglucose in vivo:high accumulation in macrophages and granulation tissues studies by microautoradiography J Nucl Med 1992;33:1972-1980.
- 9. Love C, et al. FDG PET of infection and inflammation. J Nucl Med.2005; 25: 1357-1368.
- 10. Hutan M, Satko M, Dimov A. Significance of MRI in the treatment of perianal fistula. Bratisil Lek Listy 2009;110(3):162-5.
- 11. Joyce M.Veniero JC, Magnetic resonance imaging in the management of anal fistula and anorectal sepsis. Clinical Colon Rectal Surgery 2008;21(3):213-9.
- 12. Morris J, Spencer JA, Ambrose NS. MR imaging classification of perianal fistulas and its implications for patient management. Radiographics. 2000;20(3):623-35.
- 13. Spencer JA,Chapple K, Wilson D et all. Outcome after surgery for perianal fistula: predictive value of MR imaging. AJR Am J Roentgenol. 1998;171(2):403-6.
- 14. Wahl RL. PET ve PET/BT prensipler ve uygulamalar: İnfeksiyon ve inflamasy-onun PET/BT ile görüntülenmesi. İkinci baskı. 2011; 12: 619-620.
- 15. Eugene C.Lin-Abass Alavi. PET and PET/CT A Clinical Guide 2nd edition. 2009:245.
- 16. Pellegrino D,et al. Inflammation and infection: Imaging properties of 18 F FDG PET/CT-labeled white blood cells versus 18 F FDG. J Nucl Med 2005; 46:1522-1530.
- 17. Tatlıdil R.Jadvar H.Incidental colonic FDG uptake: Corelation with colon-oskopic and histopathologic findings. Radiology 2002; 224:783-787.
- 18. Ehab M.Kamel et al. Significance of Incidental 18 F FDG Accumulations in the Gastrointestinal Tract in PET/ CT Correlation with Endoscopic and Histopathologic Results. J Nucl. Med 2004;45:1804-1810.
- 19. Zhuang H, et al.Applications of fluode-oxyglucose-PET imaging in the detection of infection and inflammation and other benign disorders. Radiol Clin N Am 2005;43:121-134.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Nuclear Medicine |
| Journal Section | Case Reports |
| Authors | |
| Publication Date | April 20, 2011 |
| Published in Issue | Year 2011 Volume: 5 Issue: 1 |
