CT anatomy of the female pelvis: a second look.

Computed tomography (CT) remains a valuable technique in the assessment of the female pelvis. The CT appearance of the normal ligamentous, vascular, and visceral anatomy of the female pelvis can be confusing. Newer high-resolution CT scanners combined with mechanical intravenous contrast medium injectors and thinner sections have substantially improved the imaging of female genital tract anatomy. In addition to the cardinal, uterosacral, and round ligaments, the ovaries and their ligamentous attachments, as well as the blood supply to the female internal organs, can now be visualized. Inferior-to-superior image acquisition following bolus administration of intravenous contrast material with an angiographic injector facilitates precise identification of the uterine artery and its relationship to the pelvic ureter and the vascular plexus supplying the vagina, ovaries, and uterine body. Ideally, familiarity with variations in the CT appearance of normal female pelvic anatomy will enable more accurate evaluation of pelvic abnormalities.