Background

Patients with hip disorders undergo multiple radiographic examinations, so gonadal radiation risk should be minimized. Inaccurate shield placement, including obscuring landmarks, has been widely reported, and some studies reported that covering the true pelvis was inappropriate to shield young girls’ ovaries. However, no reports on ovaries in Asian patients identified on magnetic resonance imaging exist. We aimed to identify the location of the ovaries in Japanese children and assess the efficacy of gonadal shielding.

Methods

Female patients aged ≤16 years who underwent magnetic resonance imaging for hip disorders that displayed at least one ovary were included. Sixty ovaries from 31 patients were classified into two age groups: <2 years and >2 years, and the ovaries' position was classified according to the following four zones on the anteroposterior pelvic radiograph: zone 1 (true pelvis) — area surrounded by the line of the anterior superior iliac spines, inner side walls of the ilium, and symphysis pubis; zone 2 — areas lateral to zone 1; zone 3 — sacral area superior to zone 1; and zone 4 — areas lateral to zone 3. The ovaries’ position was analyzed according to age group.

Results

Thirty-one ovaries in 16 patients were <2 years, and 29 ovaries in 15 patients were >2 years. Thirteen ovaries in the true pelvis, 18 ovaries in the false pelvis were <2 years, and 27 in the true pelvis and 2 in the false pelvis were in >2 years. In girls aged <2 years, most ovaries in the false pelvis were located in zone 3.

Conclusions

Girls aged >2 years mostly have their ovaries in the true pelvis, and ovaries in infants tend to be located superior to the true pelvis. Covering the true pelvis is plausible for shielding ovaries. Shields should be placed slightly more cranially than the true pelvis for infants.

中文翻译：

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儿童卵巢的位置以及髋部和骨盆放射照相中性腺屏蔽的功效

背景

患有髋关节疾病的患者要接受多次放射检查，因此应尽量减少性腺辐射风险。不准确的护罩放置位置（包括模糊地标）已被广泛报道，一些研究报告称，覆盖真正的骨盆不适合保护年轻女孩的卵巢。然而，尚无关于通过磁共振成像识别亚洲患者卵巢的报道。我们的目的是确定日本儿童卵巢的位置并评估性腺屏蔽的功效。

方法

年龄≤16岁、因髋部疾病接受磁共振成像且至少显示一个卵巢的女性患者被纳入研究。31 名患者的 60 个卵巢被分为两个年龄组：<2 岁和 >2 岁，卵巢位置根据骨盆前后位片上的以下四个区域进行分类： 区域 1（真骨盆）——被骨盆包围的区域髂前上棘、髂骨内侧壁和耻骨联合线；区域 2——区域 1 的侧面区域；区域 3 — 高于区域 1 的骶骨区域；区域 4 — 区域 3 的侧面区域。根据年龄组分析卵巢的位置。

结果

16 名患者的 31 个卵巢<2 年，15 名患者的 29 个卵巢>2 年。真骨盆中有13个卵巢，假骨盆中有18个卵巢<2岁，真骨盆有27个，假骨盆有2个>2岁。在<2岁的女孩中，大多数假骨盆中的卵巢位于3区。

结论

2岁以上女孩的卵巢大多位于真骨盆，婴儿的卵巢往往位于真骨盆上方。覆盖真正的骨盆似乎可以保护卵巢。对于婴儿来说，防护罩的放置位置应比真正的骨盆稍靠颅骨。