title: Location of the ovaries in girls from newborn to 18 years of age: reconsidering ovarian shielding.
abstract: 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.
authors.affiliation: Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA. bardod@ohsu.edu
authors.forename: Dianna M E
authors.initials: DM
authors.lastname: Bardo
authors.forename: Michelle
authors.initials: M
authors.lastname: Black
authors.forename: Kellie
authors.initials: K
authors.lastname: Schenk
authors.forename: Mario F
authors.initials: MF
authors.lastname: Zaritzky
mesh_terms: 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