'Bridging Vascular Sign' in the MR Diagnosis of Uterine Subserosal/Exophytic Leiomyoma

Kim, Jong Chul

Abstract

PURPOSE: To evaluate the usefulness of 'bridging vascular sign' in the diagnosis of a subserosal/exophyticuterine leiomyoma and the helpfulness of this sign in the differentiation of a uterine leiomyoma from adnexalmasses on pelvic magnetic resonance (MR) imaging.
MATERIALS AND METHODS
Of 20 women with a solitary pelvic massin whom pelvic MR imaging was performed during recent three years to differentiate a uterine leiomyoma from anadnexal mass, 12 with surgicopathologically proven subserosal/exophytic uterine leiomymas were included in thisstudy. The other eight women were proved to have tubo-ovarian abscess (n = 3), ovarian endometrioma (n = 2),ruptured corpus luteum cyst (n = 2), and ovarian fibroma (n = 1). A 1.5 T unit was used to obtain axial/sagittalT1- and T2-weighted and gadolinium-enhanced sagittal T1-weighted images. Positive 'bridging vascular sign' wasdefined through the retrospective review and analysis of MR findings as the presence of intervening curvilinear ortortuous signal-void vascular structures crossing the uterus and the pelvic mass. Using this sign in the diagnosisand differentiation of a uterine leiomyoma from adnexal masses, statistical significance was evaluated.
RESULTS
'Bridging vascular sign' was present in eight of 12 leiomyomas, but no in adnexal masses. Using this sign in thediagnosis and differentiation of a uterine leiomyoma from adnexal masses, sensitivity was 66.7%, specificity 100%,positive predictive value 100%, negative predictive value 66.7%, and accuracy 80%.
CONCLUSION
'Vascular bridgingsign' on MR imaging may be a useful radiologic sign in the diagnosis and differentiation of a subserosal/exophyticuterine leiomyoma from adnexal masses.