Fig. 9

Actinomycosis in a 36-year-old woman with chronic pelvic pain, rectal disorder. and dyspareunia. a Axial and (b) sagittal T2-W MR images show right subperitoneal infiltration with intermediate signal intensity, centered on the right utero-sacral ligament (thin arrows) and the sacro-recto-genital septum up to the presacral space (star) from the first sacral vertebra to the sacrococcygeal junction. c Axial T2-W MR image shows perirectal soft-tissue infiltration (arrows) with intermediate T2-signal intensity semicircumferential thickening of the upper and posterior rectum (arrowheads). d Axial T1-W fat-suppressed contrast-enhanced subtracted MR image shows avid enhancement of the surrounding inflammatory infiltration with small abscesses in the presacral space (arrows). Past medical history of intrauterine device recent removal was found