Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. May 27, 2023; 15(5): 882-891
Published online May 27, 2023. doi: 10.4240/wjgs.v15.i5.882
Diagnostic performance of texture analysis in the differential diagnosis of perianal fistulising Crohn’s disease and glandular anal fistula
Xin Zhu, Dan-Dan Ye, Jian-Hua Wang, Jing Li, Shao-Wei Liu
Xin Zhu, Jian-Hua Wang, Jing Li, Shao-Wei Liu, Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China
Dan-Dan Ye, Department of Radiology, Quanzhou Orthopedic-Traumatological Hospital, Quanzhou 362000, Fujian Province, China
Author contributions: Zhu X designed the research study; Ye DD, Li J, and Liu SW performed the research; Zhu X and Wang JH analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Institutional review board statement: This study was approved by the institutional review board of the Affiliated Hospital of Nanjing University of Chinese Medicine; informed consent was waived owing to the retrospective nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All datasets generated for this study are included in the manuscript and/or the supplementary files.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://
Corresponding author: Xin Zhu, Doctor, MD, Chief Doctor, Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, No. 155 Hanzhong Road, Nanjing 210029, Jiangsu Province, China.
Received: December 12, 2022
Peer-review started: December 12, 2022
First decision: January 2, 2023
Revised: January 16, 2023
Accepted: March 30, 2023
Article in press: March 30, 2023
Published online: May 27, 2023
Core Tip

Core Tip: Crohn's disease (CD) is a localized, segmental chronic granulomatous inflammation that can affect the digestive tract from the oral cavity to the anus, and its pathophysiology is non-caseous necrotic granuloma. Nearly 10% of patients with CD have an anal fistula before presenting gastrointestinal symptoms. At the same time, perianal fistulising CD (PFCD) and glandular anal fistula have many similarities on conventional magnetic resonance imaging (MRI); therefore, it is difficult to differentiate between these conditions in the early stages with conventional MRI. Texture analysis based on conventional MRI images can quantitatively analyze image pixel information and reflect the internal heterogeneity and pathological characteristics of the lesion. Currently, this approach is widely used to distinguish between benign and malignant tumors, predict tumor stage, and evaluate treatment efficacy. In addition to the application of texture analysis in the study of tumors or substantial organs, some studies have applied texture analysis to hollow organs such as the intestine. Many patients with PFCD show concomitant active proctitis, but only few patients with glandular anal fistula have active proctitis. Based on this theory, we analyzed the texture of the rectum and anal canal wall in the PFCD group and glandular anal fistula group in this study to explore whether the texture feature parameters are valuable in identifying and differentiating these two lesions.