A Modified Structured Magnetic Resonance Imaging Reporting for Anal Fistula: A Study onPracticality ,Timeliness and Reliability

Aim:This study sought to compare modified Structured Reports (mSRs) time-liness with Free–text Reports(FRs) and assess mSRs-related clinical practicality and reliability. Method: We included patients who underwent preoperative perianal magnetic resonance imaging (MRI) and anal fistula surgery between January 2022 and May 2023. Two radiologists independently produced narrative reports first, then completed mSRs one month later. Reporting times were compared via paired t-test. Two anorectal surgeons independently assessed clinical satisfaction (clarity, comprehensiveness, surgical guidance value), with mutual blinding to each others evaluations. Clinical satisfaction was analyzed using paired Wilcoxon test; reliability was evaluated via intraclass correlation coefficient (ICC), and agreement via Bland–Altman analysis. Results: Radiologist 1 spent more time on FRs [758.72(±256.19)] than mSRs [479.8(±182.27)]; Radiologist 2 showed similar trends (FRs: 619.24 1 (±184.68) vs. mSRs: 354.80 (±98.28)). Stratified by anal fistula subtype: Simple: Radiologist 1 completed mSRs [370.45(±73.70)] 37.6% faster than FRs [613.55(±116.61)]; Radiologist 2 saved 41.6% time (mSRs: 198.73(±46.32vs. FRs: 510.09(±99.48)).Complex: Radiologist 1 reduced time by 36.1% (mSRs: 510.69 (±192.28)vs. FRs: 799.67(±270.62)); Radiologist 2 saved 43.0% (mSRs: 370.62 (±103.56) vs. FRs: 649.74 (±192.44)).Junior physicians and associate chief physicians both rated FRs lower than mSRs across clarity, completeness, and degree of surgical guidance (all P¡0.01). For mSRs, interrater ICC was 0.644 (clarity), 0.903 (completeness), 0.700 (degree of surgical guidance; all 95% CI reported); Bland-Altman plots showed low score differences. Conclusion: A mSR significantly reduces report completion time and improves clinical satisfaction among anorectal surgeons. Moreover, it has the potential to enhance radiodiagnostic operational efficiency and exert a positive impact on surgical planning and postoperative outcomes of anal fistulas.