Suspensory ligament of the ovary

The suspensory ligament of the ovary is a thin fold of the parietal peritoneum which attaches to the lateral margin of the ovary and extends to the lateral pelvic sidewall. It is also referred to as the infundibulopelvic ligament^1,2. It should not to be confused with the ovarian ligament which is a separate structure.

Gross anatomy

The suspensory ligament of the ovary makes up the superior border of the broad ligament. It is an important supporting structure of the ovary, suspending it in the pelvis.

Attachments

• lateral ovary
• lateral pelvic sidewall

Contents

The contents of the ovarian suspensory ligament include:

• ovarian artery
• ovarian vein
• ovarian nerve plexus
• lymphatic vessels⁴

Radiographic features

The ovarian suspensory ligament is a useful anatomic landmark for localising the ovary. It is also useful for differentiating between intra- and extraovarian pathology⁴. Ovarian origin can be suspected if a pelvic mass leads towards or demonstrates a direct connection with the suspensory ligament⁵.

MRI

• on axial and sagittal T2-weighted MR images the suspensory ligament of the ovary can be identified as a narrow soft-tissue band extending from the ovary along the direction of the external iliac or common iliac artery or vein.
• following the course of the ovarian artery inferiorly from the retroperitoneum towards the ovary may help detect the ovarian suspensory ligament
• caution must be exercised in patients post hysterectomy without adnexectomy as the ovaries often change locations in this circumstance.