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World J Gastroenterol. Oct 28, 2026; 32(40): 116827
Published online Oct 28, 2026. doi: 10.3748/wjg.116827
Published online Oct 28, 2026. doi: 10.3748/wjg.116827
Magnetic resonance imaging predicts perianal fistula in Crohn’s disease
Zhen-Peng Xu, Lu Li, Yu-Gen Chen, The Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing 210029, Jiangsu Province, China
Zhen-Peng Xu, Lu Li, First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
Zhen-Peng Xu, Yan-Yan Wu, Er-Wei Cai, Department of Colorectal Surgery, The Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou 350004, Fujian Province, China
Lu Li, Department of Colorectal Surgery, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 331300, Jiangxi Province, China
Gui-Dong Sun, Yu-Gen Chen, Department of Colorectal Surgery, Jiangsu Province Hospital of Chinese Medicine, Nanjing 210029, Jiangsu Province, China
Ke Wen, Department of Colorectal Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215009, Jiangsu Province, China
Wan-Jin Shao, Department of Colorectal Surgery, Sir Run Run Shaw Hospital, Medical School, Zhejiang University, Hangzhou 310000, Zhejiang Province, China
Yu-Gen Chen, Jiangsu Province Key Laboratory of Tumor Systems Biology and Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China
Yu-Gen Chen, Jiangsu Collaborative Innovation Center of Chinese Medicine in Prevention and Treatment of Tumor, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China
Co-first authors: Zhen-Peng Xu and Lu Li.
Co-corresponding authors: Wan-Jin Shao and Yu-Gen Chen.
Author contributions: Xu ZP and Li L designed the research and wrote the first manuscript as co-first authors; Xu ZP, Li L, Sun GD, Wu YY, Cai EW, and Wen K contributed to conceiving the research and analyzing data; Xu ZP, Li L, Shao WJ and Chen YG conducted the analysis and provided guidance for the research; Shao WJ and Chen YG have played important roles in the experimental design as co-corresponding authors; all authors reviewed and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 82405396.
Institutional review board statement: This study was approved by Institutional Review Board of the Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine and Institutional Review Board of Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine.
Informed consent statement: This study was a retrospective study and was approved by the Institutional Review Board to waive patient informed consent.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Data sharing statement: No additional data are available.
Corresponding author: Yu-Gen Chen, MD, PhD, The Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, No. 155 Hanzhong Road, Qinhuai District, Nanjing 210029, Jiangsu Province, China. yugen.chen@njucm.edu.cn
Received: February 10, 2026
Revised: March 23, 2026
Accepted: May 12, 2026
Published online: October 28, 2026
Processing time: 213 Days and 21.6 Hours
Revised: March 23, 2026
Accepted: May 12, 2026
Published online: October 28, 2026
Processing time: 213 Days and 21.6 Hours
Core Tip
Core Tip: This study confirms the high value of magnetic resonance imaging (MRI) in predicting perianal fistula in Crohn’s disease (PFCD) and distinguishing it from cryptoglandular anal fistula. Transmural inflammation or active proctitis on MRI are key PFCD features, with the predictive model showing 82.6% of sensitivity and 80.8% of specificity in the discovery cohort, and even better performance in external validation. Therefore, MRI serves as a reliable non-invasive tool for early PFCD diagnosis, guiding rational treatment and helping to avoid unnecessary harm to patients.