Computed tomography of the perineum

Area of Science:

• Radiology
• Oncology
• Anatomy

Background:

• Computed tomography (CT) is crucial for assessing pelvic malignancies.
• The perineum is often excluded from standard pelvic CT scans, potentially leading to underestimation of disease.

Purpose of the Study:

• To review the CT anatomy of the perineum in multiple planes.
• To report experience with CT in evaluating pelviperineal pathology.
• To emphasize the importance of including the perineum in pelvic CT examinations.

Main Methods:

• Review of CT anatomy of the perineum in transverse, coronal, and sagittal planes in normal subjects and cadavers.
• Analysis of CT findings in 22 patients with pelviperineal pathology (16 malignancies, 6 abscesses).

Main Results:

• CT effectively visualizes perineal anatomy.
• Malignancies identified included cervix, vulva, vagina, and mesenchymoma.
• Abscesses, cellulitis, and skin ulcers were also depicted.
• Failure to scan the perineum resulted in underestimation of disease extent.

Conclusions:

• CT is the preferred imaging modality for evaluating malignancies and abscesses in the pelviperineal region.
• Including the perineum in CT scans is essential for accurate disease assessment.
• Multiplanar CT display of pelviperineal anatomy offers significant clinical potential.