History of anal cancer and anorectal fistulas with fecal incontinence. Evaluate fistulous disease. PELVIS:PROSTATE/SEMINAL VESICLES: The peripheral zone is homogeneously T2 hyperintense aside from a 3 mm T2 weighted hypointense lesion in the medial aspect of the mid gland.BLADDER: Partially distended bladder without a focal abnormality.LYMPH NODES: No enlarged pelvic lymphadenopathy.BOWEL, MESENTERY: The visualized pelvic bowel loops are normal in caliber. In the distal rectum/anal canal at the 6:00 position there is a short fluid tract extending dorsally to T2 very hypointense granulated/fibrotic tissue tract which extend caudally along the gluteal cleft to the skin surface on the right. The granulation extends caudally along the left in the ischioanal fossa towards the dorsal column of the acetabulum. Granulation tissue extends along the left aspect of the anal canal as well. There is a 1.0 x 0.5 cm fluid locule in the right intersphincteric space (series 1000 1/24) without associated rim enhancement or inflammatory changes. Overall the appearance is similar to 2004.Note is made of mild near-circumferential thickening and gradual enhancement of the anorectum, which may be treatment related without a discrete nodular component. BONES, SOFT TISSUES: Heterogeneous bone marrow signal intensity is nonspecific and may represent red marrow conversion.Thickening and enhancement of the left hamstring tendons.OTHER: No significant abnormality noted.
Complex predominantly granulated perianal fistulous tracts with a 1.0 cm fluid locule in the right intersphincteric space. Overall the configuration and extent of disease is similar to 2004 at which time there tracts were fluid filled. Mild near-circumferential thickening and gradual enhancement of the anorectum, which may be treatment related without a discrete nodular component. 