Computed tomography of the perineum

Abstract

The value of computed tomography (CT) in the assessment of pelvic malignancy is well established. However, the importance of scanning caudad to the symphysis pubis to include the perineum has not been emphasized. The CT anatomy of the perineum in the transverse, coronal, and sagittal planes planes in normal subjects and in cadaver specimens is reviewed, and experience in 22 patients with pelviperineal pathology is reported. Malignancies in 16 patients were of the cervix (seven), vulva (six), vagina (two), and a recurrent mesenchymoma (one). Six patients had abscesses; one of these had cellulitis and skin ulcers. CT clearly depicts the perineal anatomy and is the imaging method of choice for the evaluation of malignancies and abscesses originating from or extending into this anatomic space. failure to include the perineum in the CT scanning of the pelvis will result in underestimation of disease extent. Multiplanar CT display of pelviperineal anatomy has great potential application in clinical work when high resolution coronal and sagittal reconstruction of transverse scans becomes available.