Connectivity of the Superficial Muscles of the Human Perineum: A Diffusion Tensor Imaging-Based Global Tractography Study

Despite the importance of pelvic floor muscles, significant controversy still exists about the true structural details of these muscles. We provide an objective analysis of the architecture and orientation of the superficial muscles of the perineum using a novel approach. Magnetic Resonance Diffusio...

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Bibliographic Details
Published in:Scientific reports 2018-12, Vol.8 (1), p.17867-10, Article 17867
Main Authors: Zifan, Ali, Reisert, Marco, Sinha, Shantanu, Ledgerwood-Lee, Melissa, Cory, Esther, Sah, Robert, Mittal, Ravinder K.
Format: Article
Language:English
Subjects:
692/4020
692/698
Adult
Colon
Computed tomography
Diffusion Tensor Imaging
Female
Fibers
Healthy Volunteers
Humanities and Social Sciences
Humans
Magnetic resonance imaging
Male
multidisciplinary
Muscles
Muscles - anatomy & histology
Perineum
Perineum - anatomy & histology
Peripheral Nerves - anatomy & histology
Science
Science (multidisciplinary)
Sphincter
X-Ray Microtomography
Young Adult
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Summary:Despite the importance of pelvic floor muscles, significant controversy still exists about the true structural details of these muscles. We provide an objective analysis of the architecture and orientation of the superficial muscles of the perineum using a novel approach. Magnetic Resonance Diffusion Tensor Images (MR-DTI) were acquired in 10 healthy asymptomatic nulliparous women, and 4 healthy males. Global tractography was then used to generate the architecture of the muscles. Micro-CT imaging of a male cadaver was performed for validation of the fiber tracking results. Results show that muscles fibers of the external anal sphincter, from the right and left side, cross midline in the region of the perineal body to continue as transverse perinea and bulbospongiosus muscles of the opposite side. The morphology of the external anal sphincter resembles that of the number ‘8’ or a “purse string”. The crossing of muscle fascicles in the perineal body was supported by micro-CT imaging in the male subject. The superficial muscles of the perineum, and external anal sphincter are frequently damaged during child birth related injuries to the pelvic floor; we propose the use of MR-DTI based global tractography as a non-invasive imaging technique to assess damage to these muscles.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-018-36099-4