Location of the ovaries in girls from newborn to 18 years of age: reconsidering ovarian shielding.
BACKGROUND
Guidelines for ovarian shielding are to place a lead shield in the midline of the abdomen at the level of the umbilicus. However, the ovaries are routinely seen at other locations on all types of imaging examinations.


OBJECTIVE
To determine the position of the ovaries in girls, newborn to 18 years of age, in order to assess efficacy of ovarian shield placement.


METHODS
We identified 336 girls who underwent lumbar spine and pelvic MRI. Images were reviewed noting the position of the ovaries relative to anatomic landmarks: symphysis pubis, iliac crest and anterior superior iliac spine (ASIS). In 174 girls a total of 307 ovaries were visualized. The girls were divided into three age groups and analyzed together. Right and left ovaries were analyzed together. The mean, 95% confidence interval (CI), standard deviations and range were calculated.


RESULTS
The ovaries lay at or below the iliac crest (the level of the umbilicus), most often just medial to the ASIS and above the pubic symphysis in girls of all ages.


CONCLUSIONS
Current methods of shielding only the midline of the pelvis for the purpose of reducing radiation dose to the ovaries during radiographic imaging are ineffective given that the ovaries are almost always positioned laterally in the pelvis. Therefore current shielding techniques should be changed; lead ovarian shields should be placed in a lateral position or even abandoned if relevant anatomy will be obscured.
Bardo
Dianna M E
DM
Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA. bardod@ohsu.edu
Black
Michelle
M
Schenk
Kellie
K
Zaritzky
Mario F
MF
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D010053:Ovary / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods; D011859:Radiography; D012189:Retrospective Studies