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Abstract
The aim of this study was the value of current imaging techniques including perianal Fistulography, Transrectal Ultrasonography (TRUS) and Magnetic Resonance Imaging (MRI) assisment in the management of difficult anal fistulae. Its results were: Fistulography was a failure in several cases due to lack of external openings and failure to retain dye in the track and cannot detect actual relation of primary tracts to perianal structures. TRUS detect intersphincteric & transsphincteric fistulous tracks only and cannot detect secondary tracks. MRI is a real achievement in detecting primary and secondary fistulous tracks and its relation to anal musculature as well as the levator ani muscle.