Fig. 1. Sagittal T2 fast relaxation fast spin echo section of the pelvis performed with vaginal distension by endoluminal contrast. This image shows a more complex contour of the vagina than has been described previously. The distended vagina demonstrates three zones: a narrow tubular sphincteric zone at the introitus, a wedge-shaped transition zone, and an expanded forniceal zone.
Fig. 2. Sagittal T2 fast relaxation fast spin echo section of the pelvis performed with vaginal distension by endoluminal contrast. Measurements of the proximal, mid, and distal sphincteric transition and forniceal zones were taken as illustrated above. S1, introitus; S2, midpoint between S1 and S3; S3, transition between sphincteric and transition zones; T1, 1 cm above S3; T2, origin of the urethra; T3, midpoint between T2 and F1; F1, anterior fornix; F2, cervical os; F3, posterior fornix.
Table 1. Patient characteristics (N = 100)
Fig. 3. Compressed reconstruction image of the pelvis performed with vaginal distension by endoluminal contrast. This image better demonstrates the overall funnel-like configuration of the vagina and again shows the three-zone configuration. Free intraabdominal fluid and the urinary bladder also are visible.
Fig. 4. A,
Axial T2 fast relaxation fast spin echo section of the pelvis performed with vaginal distension by endoluminal contrast. In the sphincteric zone the puborectalis muscle forms a sling around the urethra, vagina, and rectum. The lateral walls of the vagina are fused with the puborectalis, the anterior wall is fused with the urethra, and the posterior wall is fused with the perineal body. B
, Coronal T2 fast relaxation fast spin echo section of the pelvis performed with vaginal distension by endoluminal contrast. Coronal images demonstrate the paracolpium connecting the lateral walls of the vagina to the pubococcygeus muscles. This determines the contour of the lateral walls of the vagina in the transition zone. Note the large endometrioma visible superior and to the left of the uterus.
Table 2. Vaginal diameters (N = 89)
Table 3. Comparisons of vagina diameter levels (N = 89)
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