Bridging vessel sign

Last revised by Mostafa Elfeky on 15 Feb 2021

The bridging vessel sign refers to an appearance of vessels coursing from the uterus into an adjoining pelvic mass (a vascular bridge). This sign helps to differentiate a pedunculated subserosal uterine leiomyoma from other juxtauterine masses of ovarian, adnexal or bowel origin.

Colour and power Doppler shows the vessels as flow signals extending from the uterus into the adjoining pelvic mass. MRI shows the vessels as curvilinear tortuous flow voids. 

The bridging vessel sign indicates the uterine origin of the pelvic mass. The vessels represent feeding vessels that arise from the uterine arteries and course through the myometrium to supply large exophytic myomas. It is reported to have a high sensitivity and specificity for the diagnosis of large (>3 cm) subserosal leiomyomas.

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