Visualización por resonancia magnética del drenaje venoso en las masas pélvicas: una ayuda para filiar su origen

• Autores: Joaquín Galant, Luis Martí Bonmatí, V. Roca, Jorge Calbo Maiques, N Picazo, A. Puerta
• Localización: Radiología, ISSN-e 1578-178X, ISSN 0033-8338, Vol. 51, Nº. 2, 2009, págs. 171-175
• Idioma: español
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• Resumen
  • español

    Objetivo Evaluar la utilidad de la detección en la resonancia magnética (RM) de un pedículo vascular ovárico y de la presencia de vasos prominentes entre el útero y las tumoraciones de gran tamaño como signos para filiar el origen de las masas en el ovario o el útero, respectivamente.

    Material y métodos Se revisan los estudios de RM de 80 pacientes con masas pélvicas >7cm y confirmadas histológicamente. Se valoró la presencia de venas gonadales que drenaran las tumoraciones y la presencia de vasos interpuestos entre la superficie de la lesión y el útero.

    Resultados Se detectaron venas gonadales que drenaban las masas pélvicas en 36 de las 43 tumoraciones de origen ovárico (84%), mientras que en 30 de las 37 tumoraciones de origen uterino se demostraron vasos interpuestos entre ellas y el útero (81%). La sensibilidad, especificidad, valores predictivos positivo y negativo de los signos de presencia de vasos gonadales drenando la lesión fueron del 84, 95, 95 y 83% para masas ováricas, y del 81, 91, 88 y 85% para los vasos interpuestos entre el útero y la masa en los miomas subserosos, respectivamente.

    Conclusión La valoración del drenaje venoso de tumoraciones pélvicas resulta de gran utilidad cuando el origen de las tumoraciones no resulta fácil de establecer.

  • English

    Objective To evaluate the usefulness of detecting at MRI an ovarian vascular pedicle or prominent vessels between the uterus and large tumors for determining whether masses originate in the ovary or uterus.

    Material and methods We reviewed MRI studies from 80 patients with histologically confirmed pelvic masses greater than 7cm in diameter. We evaluated the presence of gonadal veins draining the tumors and the presence of vessels between the surface of the lesion and the uterus.

    Results We detected gonadal veins draining the pelvic masses in 36 of the 43 tumors originating in the ovaries (84%); we detected vessels between the uterus and the pelvic mass in 30 of the 37 tumors that originated in the uterus (81%). The sensitivity, specificity, and positive and negative predictive values for the presence of gonadal veins draining the lesion were 84%, 95%, 95%, and 83%, respectively, for ovarian masses, and 81%, 91%, 88%, and 85%, respectively, for vessels between the uterus and the mass in subserous myomas.

    Conclusion Evaluating the venous drainage of pelvic tumors is very useful in cases in which it is not easy to establish the origin of the tumor.

    Objective To evaluate the usefulness of detecting at MRI an ovarian vascular pedicle or prominent vessels between the uterus and large tumors for determining whether masses originate in the ovary or uterus.

    Material and methods We reviewed MRI studies from 80 patients with histologically confirmed pelvic masses greater than 7cm in diameter. We evaluated the presence of gonadal veins draining the tumors and the presence of vessels between the surface of the lesion and the uterus.

    Results We detected gonadal veins draining the pelvic masses in 36 of the 43 tumors originating in the ovaries (84%); we detected vessels between the uterus and the pelvic mass in 30 of the 37 tumors that originated in the uterus (81%). The sensitivity, specificity, and positive and negative predictive values for the presence of gonadal veins draining the lesion were 84%, 95%, 95%, and 83%, respectively, for ovarian masses, and 81%, 91%, 88%, and 85%, respectively, for vessels between the uterus and the mass in subserous myomas.

    Conclusion Evaluating the venous drainage of pelvic tumors is very useful in cases in which it is not easy to establish the origin of the tumor.