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MR imaging of vaginal morphology, paravaginal attachments and ligaments. Normal features
VITTORIO PILONI11Iniziativa Medica, Diagnostic Imaging Centre, Monselice (Padova), Italy
Aim: :To define the MR appearance of the intact vaginal and paravaginal anatomy.
Method: :the pelvic MR examinations achieved with external coil of 25 nulliparous women (group A), mean age 31.3 range 28-35 years without pelvic floor dysfunctions, were compared with those of 8 women who had cesarean delivery (group B), mean age 34.1 range 31-40 years, for evidence of (a) vaginal morphology, length and axis inclination; (b) perineal body’s position with respect to the hymen plane; and (c) visibility of paravaginal attachments and ligaments.
Results: :in both groups, axial MR images showed that the upper vagina had an horizontal, linear shape in over 91%; the middle vagina an H-shape or W-shape in 74% and 26%, respectively; and the lower vagina a U-shape in 82% of cases. Vaginal length, axis inclination and distance of perineal body to the hymen were not significantly different between the two groups (mean ± SD 77.3 ± 3.2 mm vs 74.3 ± 5.2 mm; 70.1 ± 4.8 degrees vs 74.04 ± 1.6 degrees; and +3.2 ± 2.4 mm vs + 2.4 ± 1.8 mm, in group A and B, respectively, P > 0.05). Overall, the lower third vaginal morphology was the less easily identifiable structure (visibility score, 2); the uterosacral ligaments and the paraurethral ligaments were the most frequently depicted attachments (visibility score, 3 and 4, respectively); the distance of the perineal body to the hymen was the most consistent reference landmark (mean +3 mm, range -2 to + 5 mm, visibility score 4). A failure rate of up to 40% in the depiction of uterosacral, cardinal and round ligaments occurred in both groups.
Conclusions: :nulliparous women and women after cesarean delivery do not differ significantly in their vaginal and paravaginal anatomy. Although MR mapping seems a promising tool, failure to depict any support structure in singular cases cannot be considered evidence of abnormality.
Cite This Article
PILONI V. MR imaging of vaginal morphology, paravaginal attachments and ligaments. Normal features. 2015; 34(2): 53-59
Corresponding Author: PILONI V.
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