title: MDCT of the gonadal veins in females with large pelvic masses: value in differentiating ovarian versus uterine origin.
abstract: OBJECTIVE
  The objective of our study was to determine the usefulness of recognizing the continuity of the gonadal veins to the pelvic mass to differentiate ovarian versus uterine origin on MDCT in females with a large pelvic mass.
  
  
  METHODS
  Two radiologists interpreted the MDCT images obtained on a monitor, using paging methods, in 86 female patients with a large pelvic mass (> 8 cm) and 40 patients without an abdominopelvic mass as control subjects. The following issues were recorded using a 5-point scale: visualization of gonadal veins and origin determination based on anatomic continuity. Receiver operating characteristic (ROC) curve analysis was performed, and the interobserver differences were checked with kappa statistics. The maximum diameters of the gonadal veins were also measured. With consensus interpretations, the sensitivity, specificity, and accuracy of ovarian origin determination were calculated.
  
  
  RESULTS
  Gonadal veins were shown in more than 70% of the subjects in both the control group and the patients with a mass (hereafter referred to as the "mass group"). There was no significant difference in the diameter of the gonadal veins between the control and mass groups and between patients with an ovarian mass and those with a uterine mass. The values for the area under the ROC curve (A(z)) of the two observers for ovarian origin determination were 0.90 and 0.92. The kappa value was 0.48. The sensitivity, specificity, and accuracy were 83.3%, 87.5%, and 84.9%, respectively.
  
  
  CONCLUSIONS
  Gonadal veins can be shown on MDCT with high consistency; MDCT provides useful information for determining the origin of relatively large pelvic tumors arising in females.
authors.affiliation: Department of Clinical Radiology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. asayama@radiol.med.kyushu-u.ac.jp
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Asayama
authors.forename: Kengo
authors.initials: K
authors.lastname: Yoshimitsu
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Aibe
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nishie
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kakihira
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Irie
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tajima
authors.forename: Kunishige
authors.initials: K
authors.lastname: Matake
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nakayama
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ohishi
authors.forename: Eisuke
authors.initials: E
authors.lastname: Kaneki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D010053:Ovary / Q000098:blood supply*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D014599:Uterus / Q000098:blood supply*; D014680:Veins