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Detection of the Gonadal Veins in the Diagnosis of Transposed Ovaries in Patients with Cervical Carcinoma: A Useful Sign on MDCT

Masakazu Hirakawa1, Kengo Yoshimitsu, Daisuke Kakihara, Hiroyuki Irie, Yoshiki Asayayama, Kousei Ishigami and Hiroshi Honda

1 All authors: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.


Figure 1
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  		Fig. 1A —31-year-old woman 2 years after hysterectomy and lateral transposition of bilateral ovaries because of stage IB squamous cell carcinoma of uterine cervix. Arrows and arrowheads indicate surgical clips and gonadal veins, respectively. Bilateral gonadal veins were fully visible and given detectability score of 5 (totally detectable) by two reviewers. Early-phase CT scans through levels of S1–S2 (A), L5–S1 (B), and L4–L5 (C).

 

Figure 2
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  		Fig. 1B —31-year-old woman 2 years after hysterectomy and lateral transposition of bilateral ovaries because of stage IB squamous cell carcinoma of uterine cervix. Arrows and arrowheads indicate surgical clips and gonadal veins, respectively. Bilateral gonadal veins were fully visible and given detectability score of 5 (totally detectable) by two reviewers. Early-phase CT scans through levels of S1–S2 (A), L5–S1 (B), and L4–L5 (C).

 

Figure 3
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  		Fig. 1C —31-year-old woman 2 years after hysterectomy and lateral transposition of bilateral ovaries because of stage IB squamous cell carcinoma of uterine cervix. Arrows and arrowheads indicate surgical clips and gonadal veins, respectively. Bilateral gonadal veins were fully visible and given detectability score of 5 (totally detectable) by two reviewers. Early-phase CT scans through levels of S1–S2 (A), L5–S1 (B), and L4–L5 (C).

 

Figure 4
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  		Fig. 1D —31-year-old woman 2 years after hysterectomy and lateral transposition of bilateral ovaries because of stage IB squamous cell carcinoma of uterine cervix. Arrows and arrowheads indicate surgical clips and gonadal veins, respectively. Bilateral gonadal veins were fully visible and given detectability score of 5 (totally detectable) by two reviewers. Curved multiplanar reconstruction image shows complete course of bilateral gonadal veins as well as transposed ovaries (open arrows) and surgical clips.

 

Figure 5
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  		Fig. 2A —48-year-old woman 3 years after hysterectomy and transposition of right ovary for stage IB squamous cell carcinoma of uterine cervix. Left ovary was resected. Delayed-phase CT scan through level of iliac fossa reveals formation of cyst on transposed ovary (arrow). Surgical clips could not be detected. Arrowhead indicates gonadal vein.

 

Figure 6
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  		Fig. 2B —48-year-old woman 3 years after hysterectomy and transposition of right ovary for stage IB squamous cell carcinoma of uterine cervix. Left ovary was resected. Curved multiplanar reconstruction image shows complete course of right gonadal veins (arrowheads), as well as transposed ovary with cyst formation (arrow). Right gonadal vein was given detectability score of 5 (totally detectable) by both reviewers.

 

Figure 7
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  		Fig. 3A —33-year-old woman 2 years after hysterectomy and transposition of right ovary for stage IB squamous cell carcinoma of uterine cervix. Left ovary was resected. Early-phase CT scan through level of iliac fossa shows high-density spot at anterolateral aspect of ascending colon (arrow), mimicking contrast-filled colonic diverticulum. Dense region was subsequently identified as surgical clip by consensus. Arrowhead indicates right gonadal vein.

 

Figure 8
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  		Fig. 3B —33-year-old woman 2 years after hysterectomy and transposition of right ovary for stage IB squamous cell carcinoma of uterine cervix. Left ovary was resected. Curved multiplanar reconstruction image shows complete course of right gonadal vein (arrowhead) as well as transposed ovary (open arrow) and surgical clip (solid arrow). Right gonadal vein was given detectability score of 5 (totally detectable) by both reviewers.

 

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