Figure 5: Left-sided grade 5 perianal fistula is seen starting at 5 o'clock extending cranially for about 5.5 cm, acquiring intersphincteric location (arrow), and then supralevator extension (arrowhead). It has a small left-sided intersphincteric and perirectal cystic collection, and abscess. (asterisk) are more evident opposite 4–6 o'clock measuring 2.5 × 1.2 cm. There is more evidence of previous anal surgery with surgical suture artifact and smudged ischiorectal fat; more on the left side. (a and b) Coronal STIR images. (c and d) Axial T2 FSE images.