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Suspensory ligament of ovary

The suspensory ligament of the ovary, also called the infundibulopelvic ligament, is a peritoneal fold that extends from the ovary to the lateral pelvic wall. It carries the ovarian vessels, lymphatics, and nerves, making it a critical structure in gynecology and pelvic surgery. It is distinct from the ovarian ligament, which connects the ovary to the uterus.

This ligament is clinically important in procedures such as oophorectomy and hysterectomy, and in pathologies including ovarian torsion, pelvic masses, and vascular compromise.

Synonyms

  • Infundibulopelvic ligament

  • Lateral ligament of the ovary

  • Ovarian suspensory ligament

Attachments and Course

  • Pelvic attachment: Lateral pelvic wall, near the bifurcation of the common iliac vessels

  • Ovarian attachment: Upper pole of the ovary and the infundibulum of the uterine tube

  • Course: Runs obliquely downward and medially from the pelvic wall to the ovary, forming a conduit for vascular and neural structures

Relations

  • Anteriorly: Round ligament of the uterus and broad ligament

  • Posteriorly: Ureter and internal iliac vessels

  • Medially: Ovary and uterine tube

  • Laterally: Psoas major muscle and external iliac vessels

Function

  • Suspends the ovary in the pelvic cavity

  • Provides passage for the ovarian artery, ovarian vein, lymphatics, and sympathetic/parasympathetic nerve fibers

  • Contributes to ovarian vascular supply and venous drainage

  • Plays a role in stabilizing the ovary’s position relative to the pelvic wall

Clinical Significance

  • Important surgical landmark in oophorectomy and adnexectomy (must be ligated to control ovarian vessels)

  • Involved in ovarian torsion, where twisting may compromise ovarian blood supply

  • Can be affected by pelvic inflammatory disease, endometriosis, or tumors

  • May be seen as thickened or displaced in cases of pelvic mass or inflammation

MRI Appearance

T1-weighted images:

  • Ligament appears as a thin, low-signal intensity band

  • Ovarian vessels within the ligament may appear flow void or show hyperintensity if thrombosed

T2-weighted images:

  • Ligament shows persistent low-signal intensity

  • Ovarian vessels within appear as tubular signal voids

  • Pathology (thrombosis, inflammation) may increase signal intensity

STIR (Short Tau Inversion Recovery):

  • Ligament remains dark

  • Inflammatory or edematous changes appear as bright signal intensity

T1 Fat-Sat Post-Contrast:

  • Ligament itself shows minimal or no enhancement

  • Ovarian vessels enhance strongly and uniformly

  • Inflammation, torsion, or neoplasm involving the ligament may show irregular or heterogeneous enhancement

CT Appearance

Non-Contrast CT:

  • Seen as a soft tissue band extending from ovary to pelvic wall

  • Ovarian vessels visualized as tubular structures

  • Thrombosis appears as hyperdense filling defect within ovarian vein

Post-Contrast CT:

  • Ligament itself enhances minimally

  • Ovarian vessels enhance brightly

  • Pathology (inflammation, thrombosis, tumor spread) produces irregular or absent enhancement

MRI image

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MRI image

suspensory ligament of ovary mri sagittal image image anatomy image-img-00000-00000

CT image

suspensory ligament of ovary CT axial image anatomy image-img-00000-00000

CT image

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