Original Article

MR anatomy of the endopelvic fascia and ligaments in males

10.34057/PPj.2019.38.04.005

  • VITTORIO PILONI
  • MATTEO MAZZUCCO
  • ANDREA CHIAPPERIN
  • MATTIA BERGAMASCO

Pelviperineology 2019;38(4):118-121

Aim:

To describe the characteristics of the connective supporting system at MR imaging and its clinical impact.

Materials and Methods:

The imaging series of three hundred and fifty four consecutive men submitted to pelvic MRI between April 2012 and November 2019, were systematically reviewed for evidence of any linear hypointense structure consistent with the connective system as seen on the axial, sagittal and coronal planes using the T 2-weighted pulse sequence.

Results:

In the anterior compartment, the fundiform ligament, the puboprostatic ligaments and the suspensory penis ligaments were recognized most frequently (100 %, 87.5 % and 70 %, respectively); in the middle compartment, the neurovascular bundle contained in the posterior triangular prostatic corner, the peritoneal reflection running over the bladder and suspending the seminal vesicles and the Denonvilliers fascia were see in 55.9 %, 42.6 % and 40.9 % of cases. Besides all, the typical H-shaped morphology of the sacro recto vescicolo genito pubic fascia characterized the endopelvic fascia of the posterior compartment in up to 77.9% of cases, closely resembling the features of the sacro uterine ligaments.

Conclusions:

As it occurred in the case of female patients, MRI proves to be the imaging modality of choice to depict the anatomy of the connective tissue. This have a potential impact on the early detection of pathological processes ( tumor staging and recurrence, abscess location and spread) as well as on the pathophysiology of functional disorders.

Keywords: Endopelvic fascia; Male pelvis; Magnetic Resonance Imaging; Mesorectal fascia; Denonvilliers fascia; Sacro recto vesico genito pubic fascia