Further Reading

1. Hricak H and Carrington BM. (1991) MRI of the pelvis: a text atlas. Martin Dunitz, London. Definitive text atlas ofpelvic pathology.

2. Vinnicombe SJ and Husband JE. (1999) In: Applied radiological anatomy (Eds. Butler P, Mitchell AMW, and Ellis H). Cambridge University Press, Cambridge. Valuable overview of radiological anatomy.

3. Moore KL and Dalley AF. (1999) Clinically oriented anatomy, 4th Edn. Lippincott, Williams and Wilkins, Baltimore, Maryland. Well-illustrated clinical anatomy text.

4. Netter FH. (1989) Atlas of human anatomy. Ciba-Geigy, Summit, New Jersey. Invaluable bench reference.

5. Ryu J and Kim B. (2001) MR imaging of the male and female urethra. Radiographics 21:1169-1185. Useful review.

6. Siegelman ES, Outwater EK, Banner MP, etal. (1997) High resolution MR imaging of the vagina. Radiographics 17:1183-1203. Useful review.

7. Hussain SM, Stoker J, Lameris, JS. (1995) Anal sphincter complex: Endoanal MR imaging of normal anatomy. Radiology 197:671-677.

8. Debatin JF and Patak MA. (1999) MRI of the small and large bowel. Eur.Radiol. 9(8): 1523-1534. Useful review.

9. Coakley F and Hricak H. (2000) Radiologic anatomy of the prostate gland: a clinical approach. Radiol. Clin. North Am. 38(1): 15-30. Useful review.

10. Barentsz JO, Sager GJ and Witjes JA. (2000) MR imaging of the urinary bladder. Magn. Reson. Imaging Clin. NAm. 8(4): 853-867. Useful review.

Figure 3.1.

Transaxial T1W1 at level of L5 vertebra.

(1) Thecal sac

(2) L5 nerve root

(3) Caecum

(4) Descending colon

(5) Urachus

(6) Psoas muscle

(7) lliacus muscle

(8) Rectus abdominis muscle

(9) Gluteus maximus muscle

(10) Erector spinae muscle

(11) Right common iliac artery

(12) Right common iliac vein

(13) Left common iliac artery

(14) Left common iliac vein

(15) L5 vertebral body

(16) lliac blade

Figure 3.2.

Transaxial T1W1 at level of SI vertebra. (1) Caecum

(2) Gluteus minimus muscle

(3) Gluteus medius muscle

(4) Gluteus maximus muscle

(5) lliopsoas muscle

(6) Rectus abdominis muscle

(7) External iliac artery

(8) External iliac vein

(9) Internal iliac artery

(10) Internal iliac vein

(11)Bodyof sacrum

(12) Sacralala

(13) Body of ilium

Figure 3.3.

Transaxial T1W1 at level of mid sacrum.

(1) Sigmoid colon

(2) Small intestine

(3) Internal oblique muscle

(4) Rectus abdominis muscle

(5) lliopsoas muscle

(6) Gluteus minimus muscle

(7) Gluteus medius muscle

(8) Gluteus maximus muscle

(9) Piriformis muscle

(10) Inferior epigastric vessels

(11) External iliac artery

(12) External iliac vein

(13) Superior gluteal artery

(14) Branches of internal iliac artery and vein

Figure 3.4.

Transaxial T1W1 at level of acetabular roof.

(1) Uterus (retroverted)

(2) Rectum

(3) Rectus abdominis muscle

(4) Internal oblique muscle

(5) Sartorius muscle

(6) lliopsoas muscle

(7) Gluteus minimus muscle

(8) Gluteus medius muscle

(9) Gluteus maximus muscle

(10) Piriformis muscle

(11) Obturator internus muscle

(12) Left ovary

(13) Inferior epigastric vessels

(14) External iliac vein

(15) External iliac artery

(16) Deep circumflex iliac vessels

(17) Acetabular roof

Figure 3.5.

Transaxial T1W1 at level of femoral head.

(1) Urinary bladder

(2) Vagina

(3) Rectum

(4) Obturator externus muscle

(5) lliopsoas muscle

(6) Rectus femoris muscle

(7) Tensor fascia lata muscle

(8) Sartorius muscle

(9) Gluteus maximus muscle

(10) Piriformis muscle

(11) Obturator internus muscle

(12) Levator ani muscle

(13) Obturator vessels and nerve

(14) Common femoral vein

(15) Common femoral artery

(16) Femoral nerve

(17) Deep inguinal lymph node

(18) Superior pubic ramus

(19) Ischium

(20) Head of femur

(21) Ischiorectal/anal fossa

Figure 3.6.

Transaxial T1W1 of female pelvis at level of femoral heads (a) before and (b) after intravenous Gadolinium-DTPA.

(1) Bladder

(2) Bladder mucosa

(3) Vagina

(4) Vagina-muscle wall

(5) Vagina-submucosa

(6) Vagina-lumen

(7) Paracolpos

(8) Rectum

(9) Obturator internus muscle

(10) Blood vessels in paracolpos

Figure 3.7.

Transaxial T1W1 of female pelvis at level of symphysis pubis (a) before and (b) after intravenous Gadolinium-DTPA.

(1) Urethra

(2) Urethra-striated muscle layer

(3) Urethra-smooth muscle layer and submucosa

(4) Urethra-lumen

(5) Vagina

(6) Vagina-muscle wall

(7) Vagina-lumen

(8) Anal canal

(9) Anococcygeal body

(10) Levator ani muscle

(11) Obturator internus muscle

Figure 3.8.

Transaxial T1W1 of male pelvis at level of symphysis pubis (a) before and (b) after intravenous Gadolinium-DTPA

(1) Prostate

(2) Prostate—periurethral region

(3) Prostate—central and peripheral zone

(4) Anal canal

(5) Levator ani muscle

(6) Obturator internus muscle

(7) Anococcygeal raphe

(8) Coccyx

(9) Natal cleft

(10) Symphysis pubis

Figure 3.9.

Transaxial T1W1 of male pelvis at level of perineum (a) before and (b) after intravenous Gadolinium-DTPA.

(1) Deep dorsal vein of penis

(2) Urethra

(3) Urethra-striated muscle layer

(4) Urethra-smooth muscle layer and submucosa

(5) Urethra-lumen

(6) Perineal body

(7) Anal canal

(8) Ischioanal fossa

(9) Ischial tuberosity

(10) Inferior pubic ramus

Figure 3.10.

Transaxial T1W1 at level of symphysis pubis.

(1) Anal canal

(2) Ischioanal fossa

(3) Pectineus muscle

(4) Obturator externus muscle

(5) Obturator internus muscle

(6) Sartorius muscle

(7) Rectus femoris muscle

(8) Tensor fascia lata muscle

(9) lliopsoas muscle

(10) Vastus lateralis muscle

(11) Gluteus maximus muscle

(12) Gemellus muscle

(13) Body of pubis

(14) Neck of femur

(15) Greater trochanter of femur

(16) Ischial tuberosity

Figure 3.11.

Coronal T1W1 of female posterior abdomen and pelvis.

(2) Spleen

(3) Right kidney

(4) Thecal sac

(5) Rectum

(6) Retroverted uterus

(7) Psoas muscle

(8) Quadratus lumborum muscle

(9) Gluteus maximus muscle

(10) Piriformis muscle

(11) Levator ani muscle

(12) Inferior gluteal artery and vein

(13) Ischioanal fossa

(14) llium

(15) Sacral alum

(16) Body of sacrum

Figure 3.12.

Coronal T1W1 of female mid-abdomen and pelvis.

(2) Ascending colon

(3) Descending colon

(4) Uterus

(5) Psoas muscle

(6) lliacus muscle

(7) Gluteus maximus muscle

(8) Obturator internus muscle

(9) Obturator externus muscle

(10) Adductor brevis muscle

(11) Adductor longus muscle

(12) Right renal artery

(13) Abdominal aorta

(14) Left renal artery

(15) Right common iliac vein

(16) Right common iliac artery

(17) Left common iliac artery

(18) lliac blade

(19) Acetabulum

(20) Head of femur

Figure 3.13.

Coronal T1W1 of male mid abdomen and pelvis.

(2) Urinary bladder

(3) Prostate

(4) Transversus abdominis muscle

(5) Internal oblique muscle

(6) External oblique muscle

(7) Psoas muscle

(8) lliacus muscle

(9) Gluteus medius muscle

(10) Inferior vena cava

(11) Right renal artery

(12) Left renal artery

(13) Abdominal aorta

(14) Left renal vein

(15) Left testicular artery

(16) Left testicular vein

(17) llium

(18) Acetabulum

(19) Head of femur

(20) Superior pubic ramus

(21) Body of pubis

(22) Symphysis pubis

Figure 3.14.

Coronal T1W1 of female anterior abdomen and pelvis.

(2) Transverse colon

(3) Small intestine

(4) Urinary bladder

(5) lliopsoas muscle

(6) Gluteus medius muscle

(7) Gluteus minimus muscle

(8) Psoas muscle

(9) Rectus femoris muscle

(10) Adductor longus muscle

(11) External iliac vessels

(12) llium

(13) Superior pubic ramus

(14) Symphysis pubis

Figure 3.15.

Sagittal T2W1 of female pelvis.

(1) Urinary bladder

(2) Urethra

(3) Muscular layer of bladder wall

(4) Outer myometrium

(5) Junctional zone

(6) Endometrium

(7) Plane of uterocervical junction

(8) Cervical lumen

(9) Cervical mucosa

(10) Cervix (fibromuscular layer)

(11) Cervix (outer layer)

(12) Ectocervical mucosa

(13) Posterior vaginal fornix

(14) Nabothian cyst

(15) Vaginal lumen containing secretions

(16) Vaginal wall (submucosal and muscle layers)

(17) Vaginal adventitia and venous plexus

(18) Rectovaginal septum

(19) Rectum

(20) Recto-uterine space (Pouch of Douglas) containing small volume of fluid.

(21) Prevesical space

(22) Retropubic space

(23) Introitus

(24) Anal canal

(25) Rectus abdominis muscle

(26) Pubic bone and symphysis

(27) Sacrum

Figure 3.16.

Transaxial T2W1 of female pelvis at level of acetabular roof.

(1) Uterus

(2) Parametrium

(3) Right ovarian follicular cyst

(4) Caecum

(5) Rectum

(6) Perirectal fat

(7) Perirectal fascia

(8) Perirectal fascia

(9) Peritoneum

(10) Round ligament of ovary

(11) Rectus abdominis muscle

(12) External oblique muscle

(13) lliopsoas muscle

(14) Piriformis muscle

(15) Gluteus medius muscle

(16) Gluteus maximus muscle

(17) Internal iliac vessels

(18) External iliac vein

(19) External iliac artery

(20) Sacrum

(21) Acetabular roof

Figure 3.17.

Transaxial T2W1 of female pelvis at level of symphysis pubis.

(1) Urethra-striated muscle layer

(2) Urethra-smooth muscle layer and submucosa

(3) Urethra-mucosal layer

(5) Vagina—mucus secretions and inner mucosal layer

(6) Vagina—submucosa and smooth muscle layer

(7) Vagina—adventitia and venous plexus

(8) Pubourethral and periurethral ligaments

(9) Rectum

(10) Anococcygeal ligament

(11) Ischiorectal/anal fossa

(12) Levator ani muscle

(13) Sartorius muscle

(14) Rectus femoris muscle

(15) lliopsoas muscle

(16) Pectineus muscle

(17) Adductor longus muscle

(18) Adductor brevis muscle

(19) Obturator externus muscle

(20) Obturator internus muscle

(21) Gluteus maximus muscle

(22) Deep dorsal vein of clitoris

(23) Common femoral vessels

(24) Symphysis pubis

(25) Body of pubis

(26) Femur

(27) Ischium

Figure 3.18.

Transaxial T2W1 of female pelvis below symphysis pubis.

(1) Clitoris

(2) Corpus cavernosum

(3) Urethra

(4) Urethropelvic (parapelvic) ligament

(5) Paraurethral ligament

(6) Vagina—mucus secretions and inner mucosal layer

(7) Vagina—submucosa and smooth muscle layer

(8) Vagina—adventitia and venous plexus

(9) Anal canal—internal sphincter

(10) Anal canal—external sphincter and longitudinal muscle layer

(11) Ischioanal fossa

(12) Levator ani muscle—puborectalis portion

(13) Sciatic nerve

(14) Inferior gluteal vessels

(15) Pudendal vessels

(16) Inferior pubic ramus

(17) Ischium

Figure 3.19.

Coronal T2W1 of female mid-pelvis.

(1) Cervical lumen

(2) Cervical mucosa

(3) Cervix (fibromuscular layer)

(4) Cervix (outer layer)

(5) Nabothian cyst

(6) Paracervix containing venous plexus

(7) Bladder

(8) Peritoneum

(9) Recto-sigmoid junction

(10) Posterior wall of vagina and vaginal adventitia

(11) Ischioanal fossa

(12) Sacral nerve root component of sciatic nerve

(13) Gluteus medius muscle

(14) Piriformis muscle

(15) Obturator internus muscle

(16) Levator ani muscle

(17) Internal iliac vessels

(18) Sacralala

(19) llium

(20) Ischium

Figure 3.20.

Coronal T2W1 of female anterior pelvis.

(1) Endometrium

(2) Uterus—junctional zone

(3) Outer myometrium

(4) Ovarian follicular cyst

(5) Bladder

(6) Broad ligament of uterus

(7) Sigmoid colon

(8) Small intestine

(9) Urethra

(10) Peritoneum

(11) Psoas muscle

(12) lliacus muscle

(13) Obturator internus muscle

(14) Obturator externus muscle

(15) Adductor magnus muscle

(16) Acetabulum

(17) Head of femur

Figure 3.21.

Coronal T2W1 of female pelvis through symphysis pubis.

(1) Crura of clitoris

(2) Body of clitoris

(3) Vestibule

(4) Labia majora

(5) Bladder

(6) Endometrium

(7) Uterus—junctional zone

(8) Outer myometrium

(9) Psoas muscle

(10) lliacus muscle

(11) Obturator externus muscle

(12) Adductor brevis muscle

(13) Pectineus muscle

(14) External iliac vessels

(15) Acetabulum

(16) Femoral head

Figure 3.22.

Sagittal T2W1 image of male pelvis.

(1) Prostate with benign prostatic hypertrophy in central zone

(2) Peripheral zone

(3) Seminal vesicle

(4) Bladder

(5) Bladder trigone

(6) Retropubic space

(7) Urogenital diaphragm

(8) Anal canal

(9) External sphincter

(10) Anococcygeal body

(11) Anococcygeal ligament

(12) Rectum

(13) Corpus cavernosum

(14) Corpus spongiosum

(15) Symphysis pubis

(16) Sacrum

(17) Sacral canal

(18) Coccyx

Figure 3.23.

Transaxial T2W1 of male pelvis.

(1) Rectum

(2) Fat in perirectal space

(3) Perirectal fascia enclosing mesorectum

(4) Seminal vesicle

(5) Vas deferens

(6) Urinary bladder

(7) Perivesical venous plexus

(8) Wound scar

(9) Rectus abdominis muscle

(10) Obturator internus muscle

(11) Gluteus maximus muscle

(12) Common femoral vein

(13) Common femoral artery

(14) Femoral nerve

(15) Obturator vessels and nerve in obturator foramen

(16) Head of femur

(17) Acetabulum

(18) Sacrum

Figure 3.24.

Transaxial T2W1 of male pelvis.

(1) Rectum

(2) Fat in perirectal space

(3) Seminal vesicle

(4) Bladder

(5)Scar

(6) Rectus abdominis muscle

(7) Obturator internus muscle

(8) Levator ani muscle

(9) Gluteus maximus muscle

(10) Sciatic nerve

(11) Superficial inguinal lymph node

(12) Common femoral artery

(13) Common femoral vein

(14) Inferior gluteal vessels

(15) Head of femur

(16) Acetabulum

(17) Sacrum

Figure 3.25.

Transaxial T2W1 of male pelvis at level of prostate gland showing benign prostatic hypertrophy (BPH).

(1) Rectum

(2) Denonvilliers fascia

(3) Prostate—peripheral zone

(4) Urethra

(5) Surgical pseudo-capsule

(6) Prostate—transitional zone with benign prostatic hypertrophy

(7) Prostatic capsule (see text)

(8) Vesicoprostatic venous plexus

(9) Bladder

(10) Pectineus muscle

(11) Obturator internus muscle

(12) Muscular slips of levator ani muscle

(13) Gluteus maximus muscle

(14) Common femoral vein

(15) Common femoral artery

(16) Obturator vessels and nerve in obturator foramen

(17) Head of femur

(18) Acetabulum

(19) Sacrum

Figure 3.26.

Transaxial T2W1 of male pelvis at level of prostate gland.

(1) Ano-rectum

(2) Denonvilliers fascia

(3) Prostate—peripheral zone

(4) Prostate—central gland

(5) Prostatic capsule (see text)

(6) Prostate—fibromuscular band

(7) Bladder base

(8) Ischioanal fossa

(9) Spermatic cord

(10) Rectus abdominis muscle

(11) Pectineus muscle

(12) Obturator internus muscle

(13) Gluteus maximus muscle

(14) Levator ani—puborectalis portion

(15) Obturator nerve and vessels

(16) Common femoral vein

(17) Common femoral artery

(18) Head of femur

(19) Acetabulum

Figure 3.27.

Transaxial T2W1 of male pelvis at level of symphysis pubis.

(1) Anococcygeal body

(2) Anal canal

(3) Urethra

(4) Retropubic space

(5) Ischioanal fossa

(6) Sciatic nerve

(7) Levator ani—puborectalis portion

(8) Pectineus muscle

(9) Obturator externus muscle

(10) Obturator internus muscle

(11) Gluteus maximus muscle

(12) Common femoral vein

(13) Common femoral artery

(14) Pubic symphysis

(15) Ischial tuberosity

Figure 3.28.

Transaxial T2W1 of male pelvis at level of perineal body.

(1) Anal canal

(2) Internal sphincter

(3) Longitudinal muscle layer in intersphincteric space

(4) External sphincter

(5) Anococcygeal body

(6) Perineal body

(7) Ischioanal fossa

(8) Bulb of penis

(9) Crus of penis

(10) Corpus cavernosum

(11) Urethra

(12) Pectineus muscle

(13) Adductor longus muscle

(14) Adductor brevis muscle

(15) Obturator externus muscle

(16) Gluteus maximus muscle

(17) Common femoral vessels

(18) Ischial tuberosity

(19) Inferior pubic ramus

Figure 3.29.

Coronal T2W1 of posterior male pelvis.

(1) Seminal vesicle

(2) Ductus deferens

(3) Ampulla of rectum

(4) Anal canal

(5) External anal sphincter

(6) Levator ani muscle

(7) Psoas muscle

(8) lliacus muscle

(9) Obturator internus muscle

(10) Common iliac vessels

(11) llium

(12) Ischium

(13) Head of femur

Figure 3.30.

Coronal T2W1 of male pelvis.

(1) Prostate—central gland (transitional zone with benign prostatic hypertrophy—see text)

(2) Prostate—peripheral zone

(3) Prostatic capsule (see text)

(4) Urinary bladder

(5) Perineal body

(6) Ischiocavernous muscle

(7) Levator ani muscle

(8) Obturator internus muscle

(9) Psoas muscle

(10) lliacus muscle

(11) Acetabulum

(12) Head of femur

(13) Ischium

Figure 3.31.

Coronal T2W1 of anterior male pelvis.

(1) Bulb of penis

(2) Crus of penis

(3) Urogenital diaphragm

(4) Prostate—peripheral zone

(5) Prostate—central gland

(6) Prostatic capsule (see text)

(7) Prostatic venous plexus

(8) Urinary bladder

(9) Ischiocavernosus muscle

(10) Levator ani muscle—levator prostate portion

(11) Obturator internus muscle

(12) Obturator externus muscle

(13) Psoas muscle

(14) lliacus muscle

(15) llium

(16) Acetabulum

(17) Head of femur

(18) Ischium

Figure 3.32.

Coronal T2W1 of male pelvis through symphysis pubis.

(1) Prostate—Fibromuscular band

(2) Bladder

(3) Suspensory ligament of penis

(4) Urethra

(5) Corpus spongiosum

(6) Corpus cavernosum

(7) Obturator externus

(8) External iliac vessels

(9) Body of pubis

(10) Symphysis pubis

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