Topics

Topic

design image
Uterine artery

The uterine artery is a major branch of the anterior division of the internal iliac artery, supplying the uterus and playing a vital role in the vascularization of female pelvic organs. It arises in the pelvis, courses medially within the broad ligament, and crosses above the ureter (clinically remembered as “water under the bridge”) before reaching the cervix and ascending along the lateral aspect of the uterus.

The artery gives off multiple branches: ascending branches to the uterine body and fundus, descending branches to the cervix and vagina, and arcuate branches within the myometrium that form an extensive anastomotic network with the ovarian artery. This dual supply is especially important during pregnancy, uterine pathology, and surgical procedures.

The uterine artery is clinically significant in uterine fibroid embolization (UFE), hysterectomy, cesarean sections, postpartum hemorrhage management, and gynecological oncology. Variations in its course or origin are common and must be identified during imaging and surgery.

Synonyms

  • Arteria uterina

  • Uterine branch of internal iliac artery

Function

  • Provides the main arterial supply to the uterus (body, fundus, cervix)

  • Supplies blood to the vagina, fallopian tubes, and anastomoses with ovarian arteries

  • Essential for endometrial growth, pregnancy, and uterine healing

  • Target artery for embolization in fibroid treatment and postpartum hemorrhage

MRI Appearance

T1-weighted images:

  • Appears as a linear hypointense vessel along the lateral uterine border, surrounded by fat planes

  • Difficult to trace without contrast

T2-weighted images:

  • Artery: signal void

  • Prominent in pregnancy or hypervascular states due to enlarged lumen

STIR:

  • Suppresses fat, enhancing vessel conspicuity within broad ligament

  • Highlights surrounding edema or inflammatory changes

T1 Fat-Suppressed Post-Gadolinium:

  • Uterine artery enhances brightly and homogeneously

  • Demonstrates branching pattern into arcuate vessels

  • Useful for mapping in fibroid embolization and tumor angiogenesis

MRA Pelvis with Gadolinium:

  • Excellent for vascular mapping of uterine artery and branches

  • Shows origin from internal iliac artery, course around ureter, and distribution along uterus

  • Detects variants, stenosis, aneurysms, and hypertrophy (as in fibroids or pregnancy)

  • Essential pre-procedure tool for uterine artery embolization (UAE)

CT Appearance

Non-contrast CT:

  • Artery appears as a small tubular structure; often poorly visualized

  • May show calcification in older patients

CT Post-Contrast:

  • Uterine artery enhances vividly along lateral uterine wall

  • Enlarged in pregnancy, fibroids, or arteriovenous malformations

CT Angiography (CTA):

  • Best for non-invasive uterine artery mapping

  • Demonstrates origin, course, branches, and anastomoses with ovarian arteries

  • Detects active pelvic hemorrhage, AVMs, aneurysms, or fibroid vascularity

  • Critical for interventional radiology planning (UAE, pelvic trauma embolization)

CT VRT 3D image

Uterine artery CT 3D VRT anatomy image

CT image

Uterine artery CT axial image MRI axial anatomy image-img-00000-00000

CT image

Uterine artery CT axial image MRI axial anatomy image-img-00000-00000_00001

MRI image

Uterine artery MRI axial image MRI axial anatomy image-img-00000-00000