anteriore Rektozele

Dynamic

magnetic resonance imaging of the female pelvic floor—a pictorial review. Importance of the evacuation phase. (a, b, c) Sagittal midline TrueFISP images at rest (a), during straining (b), and evacuation (c) of a patient with descending perineal syndrome with tricompartimental prolapse, anterior rectocele, and rectal mucosa intussusception. Note that, although in the straining phase (b) the H and M lines (blue and right green lines) are already above the normal values, indicating a descending perineal syndrome, and a mild bulge of the anterior rectal wall is seen (white arrow), only in the evacuation phase (c) the true pelvic floor disorder is adequately characterized, with a tricompartimental prolapse (cystocele, uterine prolapse, and rectal prolapse) the true size of the rectocele is documented (orange line: 4.8 cm) and the rectal mucosa intussusception is depicted (red arrow). Left green line: extent of cystocele; purple line: extent of uterine prolapse; black line: normal expected contour of the anterior anorectal wall; red line: PCL line

Dynamic

magnetic resonance imaging of the female pelvic floor—a pictorial review. Moderate cystocele with urethral hypermobility. (a, b) Sagittal midline TrueFISP images at rest (a) and during evacuation (b), demonstrating descent of the bladder during evacuation (green line—3.8 cm) below the PCL (red line), as well as horizontalization of the urethral axis during defecation (white arrows). Note also an anterior rectocele in (b)

Dynamic

magnetic resonance imaging of the female pelvic floor—a pictorial review. Small rectoceles. Sagittal midline TrueFISP image during evacuation, showing both anterior and posterior small rectoceles. Black lines: normal expected contours of the anorectal wall; orange lines: extent of the rectoceles: 13 mm anterior and 9 mm posterior

Dynamic

magnetic resonance imaging of the female pelvic floor—a pictorial review. Moderate anterior rectocele. (a, b) Sagittal midline TrueFISP images at rest (a) and during evacuation (b) revealing a moderate anterior rectocele (orange line: 37 mm). Note also a cystocele (green line) and a rectal intra-anal intussusception (white arrow). Red line: PCL line; black line: normal expected contour of the anterior anorectal wall

Dynamic

magnetic resonance imaging of the female pelvic floor—a pictorial review. Descending perineal syndrome with tricompartimental prolapse and anterior rectocele. (a, b) Sagittal midline TrueFISP images at rest (a) and during evacuation (b). H line (blue line) measures 5.6 cm (a) and 9.5 cm (b) and the M line (green line) measures 1.3 cm (a) and 4.7 cm (b), demonstrating widening and descent of the levator hiatus. Note the vertical orientation of the levator plate (white arrow). It is also associated with a tricompartimental prolapse and an anterior rectocele (*)

Low

enterocele and anterior rectocele on defecography. Rectum after defecation showing the low enterocele and an anterior rectocele.