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Related Experiment Videos

Dynamic imaging of the normal pelvic floor

V Piloni1, G Bassotti, P Fioravanti

  • 1Servizio di Radiologia, Istituto Geriatrico, Ancona, Italy.

International Journal of Colorectal Disease
|January 1, 1997
PubMed
Summary

Direct Coronal CT scans reveal physiological overstretching of the levator ani muscle during straining. These findings in pelvic floor structures can be predicted at rest, aiding in understanding pelvic floor dynamics.

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Area of Science:

  • Radiology
  • Anatomy
  • Pelvic Floor Imaging

Background:

  • Pelvic floor dysfunction affects many individuals.
  • Accurate physiological data for pelvic floor structures is crucial for diagnosis and treatment.
  • Cross-sectional imaging offers a modern approach to assessing these structures.

Purpose of the Study:

  • To establish normal physiological values for pelvic floor structures using Direct Coronal CT.
  • To quantify changes in pelvic floor anatomy during rest and straining.
  • To assess the reliability of CT measurements for pelvic floor assessment.

Main Methods:

  • 27 subjects (20 female, 7 male, aged 20-75) without pelvic floor dysfunction underwent Direct Coronal CT scanning.
  • Scans were performed in a seated position at rest and during straining.

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  • Measurements included levator ani muscle length, levator-anal angle, rectal floor-to-ischial line distance, and supra/infralevator spaces.

    • Main Results:

    • High intra- and interobserver agreement (>80%) for CT measurements.
    • Significant differences in all measured parameters between rest and straining positions.
    • The posterior compartment showed shorter levator ani muscle length and smaller supralevator space at rest, increasing significantly on straining.

    Conclusions:

    • Direct Coronal CT provides reliable quantitative data on pelvic floor anatomy.
    • The coccygeus muscle (posterior levator ani) undergoes 'physiological overstretching' during straining.
    • Supralevator space behavior is predictable at rest, offering insights into pelvic floor function.