Anatomic approach to the parametrium: value of computed tomographic in vitro study compared to dissection

The aim of this study is to describe the morphology of the normal parametrium by correlating the slices obtained with computed tomography of 12 female cadavers studies after intravascular injection of latex with the dissection findings in 6 of the these patients. the upper limit, represented by the isthmus was defined by the uterine a. and/or a superficial uterine v. and/or the coronary v. (Charpy). The lower limit corresponded to the insertion of the levator ani mm. at the junction of the middle and inferior thirds of the vagina. The paracervical and paravaginal tissues above the levator ani m. and medial to the pelvic fascia covering these muscles were perfectly visualized. The posterior limit, formed by the lateral ligament of the rectum and/or the sacrouterine ligaments, and the anterior limit determined by the umbilico-vesical fascia were more difficult to demonstrate. In this study the parametrium appeared as a highly vascular and essentially venous connective structure with a variable morphology dependent on the uterine position.