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Grade 4 perianal fistula; transsphincteric fistula with an abscess. Axial T1-weighted (A) and fat-suppressed T2-weighted (B), coronal T2-weighted (D) and fat-suppressed T2-weighted (E), coronal and axial (C, F) contrast-enhanced fat-suppressed T1-weighted MR images show a horseshoe abscess in the intersphincteric space and extending to the ischioanal fossa (arrows) and prominent inflammation around the tract (arrowheads).
