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Published in: International Urogynecology Journal 1/2013

01-01-2013 | Original Article

Cardinal and deep uterosacral ligament lines of action: MRI based 3D technique development and preliminary findings in normal women

Authors: Luyun Chen, Rajeev Ramanah, Yvonne Hsu, James A. Ashton-Miller, John O. L. DeLancey

Published in: International Urogynecology Journal | Issue 1/2013

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Abstract

Introduction and hypothesis

The cardinal ligament (CL) and deep uterosacral ligament (US) play a critical role in utero-vaginal support. This study aims to quantify their geometrical relationships in living women using a MRI-based 3D technique.

Methods

The angles between ligaments, the ligaments length and curvature were assessed on 3D models constructed from twenty MRIs of volunteers with normal support. How angle variation theoretically affects ligament tension was investigated using a simplified biomechanical model.

Results

The CLs are 18.1 ° ± 6.8 °(SD) from the cephalic-caudal body axis , and the USs are dorsally directed and 92.5 ° ± 13.5 from the body axis. The CLs are longer and more curved than US. The theoretical calculated tension on CL is 52 % larger than that on US.

Conclusions

The CL is relatively parallel to the body axis while the US is dorsally directed. The tensions on these ligaments are affected by their orientations.
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Metadata
Title
Cardinal and deep uterosacral ligament lines of action: MRI based 3D technique development and preliminary findings in normal women
Authors
Luyun Chen
Rajeev Ramanah
Yvonne Hsu
James A. Ashton-Miller
John O. L. DeLancey
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 1/2013
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-012-1801-4

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