 Hello person man, I am Dr. Tanjana N from Micromedical College and Research Institute. I would like to thank Indian radiologist for this opportunity. My paper presentation is on the role of magnetic resonance crystallogram in free operative assessment of enorectal fistulas and its correlation with the interoperative findings. Introduction, crystallogram is defined as an abnormal connection between the two structure or the organs or between the organ or between an organ and the surface of the poly. Here is a viewer, it is an abnormal connection between the anal canal and the skin of the perineum. Its prevalence is above 0.01% and it occurs approximately 10 out of 1 that person and it has a main preformalness. Young men are commonly affected, tuberculosis and inflammatory bowel diseases are also associated with the perineal fistulas. Enorectal fistulas can be inter-springtric, trans-pringtric, extra-springtric or supra-springtric. Detailed understanding of the enorectal anatomy is needed for the identification and the management of the enorectal fistulas. Objective, to study the role of myMR fistulogram in free operative assessment of the enorectal fistulas, to identify the fistulas' tracks, internal opening and relationship of the perineal fistulas with the anal-springtric complex to correlate MR findings with interoperative findings. MR appearance in enorectal fistulas and enhanced T1 weighted images provide an excellent anatomic overview of the splinter complex, libator plate and astreorectal posa, fistula strapped inflammation and the apparatus appears as the area of a load to intermediate signal intensity and may not be distinguished from the normal structure such as the ars splinters and elevator in a muscle. At immediate post-op evaluation, the enourage produces high signal intensity on T1 weighted images and thus may be differentiated from the residual tracks. T2 weighted images provide a good contrast between the hyper-intense fluid in the track and the hypo-intense fibrous wall of the fistula and allow the adequate differentiation of the anatomic boundaries between the internal and external printers. Active fistula strapped and extensions have a high signal intensity on T2 weighted images while the sprinters and muscle have a low signal intensity. Conic fistula strapped or the scar appear as an area of load signal intensity on both T1 and T2 weighted images. Abscess also have a high signal intensity on T2 weighted images due to presence of the pus in the central cavity. On a gadolinium-enhanced fat-suppressed T1 weighted images, fistula strapped and the active granulation tissue demonstrate an intense enhancement while the fluid in the track remain hypo-intense. Methodology, the source of data. This is a hospital-based study. The source of the data is from the study will be the patient referred to the department of radiodiagnosis, mycer medical college and research institute mycer. It is a descriptive study and the duration of the study was 18 months. Methodology of study consists of MR-pyschidogram will be performed using a BOLU-coil of 1.5 FyMR, FGE medical systems. Informed and written content is taken from all the patients and the following MR sequences will be acquired. Oblique axial and coronal T1 weighted fast pin echo, T2 weighted fast pin echo, then a pad-suppressed oblique axial and coronal T1 and T2 fast pin echo, coronal and axial steps and contest enhanced oblique axial, coronal, societal, pad-sat, T1 weighted, fast pin echo. The contest was a gallo-denium 0.1 mmol per kg at a rate of 1 ml per second. Inclusion criteria is all the patients with a clinical suspicion of perineal fistula referred to M4 MRI, irrespective of the age and sex. Exclusion criteria, patient having histioprostophobia or histiopo-metallic implant insertion, cardiac pacemaker and metallic foreign body institute, patient in whom intraoperative follow-up could not be done. Then results and study. This is the distribution for age and there were 5 patients below 30 years. There were 10 patients in the age group of 31 to 40, there were 9 patients in the age group of 41 to 50 and there were 5 patients in the age group of 51 to 60 and there were 3 patients aged more than 60 years. Then according to text distribution of total 32 patients included in the study 20 were male and 12 patients were female. And this is the distribution of internal and external opening. External opening number of patients were at 28 with a single external opening and multiple external opening were 4. And internal opening, when analyzing the internal opening it was a single opening in 78.1% of the patients that is 25 out of 32 and multiple in about 5 patients that is 15.6%. Then our secondary tracts. In our study 10 out of 32 patients that is 31.3% had secondary tracts and the abscess in our study the abscess was identified in 7 out of 32 patients which corresponds to 21.9%. According to change in our grading the study that the grade 1 fistula were the commonest which was found in 11 patients that is 34.4%. The second most common is the grade 3 fistulas which was found in 9 patients and grade 2 fistulas were found in 6 patients and grade 4 and grade 5 fistulas were relatively uncommon and were found in 4 patients that is 12.5% under 2 patients that is 6.3% respectively. The sensitivity and specificity of the MRI for grade 1 and grade 5 were in the order of 80 to 100% and for grade 5 was 96.4% and 100% respectively and for the other grades the sensitivity and the specificity was 100%. So this is the image showing high signal intensity between the sphincter which corresponds to grade 1 a simple linear inter sphincter fistula and in the second image we can see a high signal intensity collection in the issuerectal space and a linear high intensity tract between the anal canal and the between the anal canal and the subcutaneous collection which corresponds to grade 2 inter sphincter fistula with abscess and this is the great trans sphincter fistula in which a linear high intensity tract noted by the traversing the sphincter and this is the grade 4 trans sphincter fistula with abscess and secondary tracts and this is grade 5 which is a supra-liberator and trans-liberator this is conclusion perineal fistula though an uncommon problem may be chronic and recurrent it may present different numerous complications like secondary tract, arches, cavities incomplete evaluation of these complications can result in residual and recurrent disease Contestinal MR can identify active information of the tract and rate is also we can also distinguish between the scar and granulation tissue 3D T1 patch that sequence is the best under time trading sequence for imaging of perineal fistulas correct identification of the perineal fistula and proper grading of the fistula are necessary for ensuring optimal surgical outcome these are my references thank you