Imaging Appearance and Nonsurgical Management of Pelvic Venous                     Congestion Syndrome

Bookwalter, Candice A.; VanBuren, Wendaline M.; Neisen, Melissa; Bjarnason, Haraldur

doi:10.1148/rg.2019180159

Cited by 57 publications

(58 citation statements)

References 45 publications

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“…5) [13,14]. The definite prevalence of NCS is unclear due to the high variability in clinical manifestations [15,16]. Some anatomical variants may cause NCS.…”

Section: Nutcracker Syndromementioning

confidence: 99%

CT imaging findings of abdominopelvic vascular compression syndromes: what the radiologist needs to know

et al. 2020

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Abdominopelvic vascular compression syndromes include a variety of uncommon conditions characterized by either extrinsic compression of blood vessels by adjacent anatomical structures (i.e., median arcuate ligament syndrome, nutcracker syndrome, May-Thurner syndrome) or compression of hollow viscera by adjacent vessels (i.e., superior mesenteric artery syndrome, ureteropelvic junction obstruction, ureteral vascular compression syndromes, portal biliopathy). These syndromes can be unexpectedly diagnosed even in asymptomatic patients and the predisposing anatomic conditions can be incidentally discovered on imaging examinations performed for other indications, or they can manifest with atypical abdominal symptoms and acute complications, which may lead to significant morbidity if unrecognized. Although computed tomography (CT) is an accurate noninvasive technique for their detection, the diagnosis remains challenging due to the uncommon clinical presentation and often overlooked imaging features. Dynamic imaging may be performed in order to evaluate patients with inconstant symptoms manifesting in a specific position. The purposes of this paper are to review the CT imaging findings of abdominopelvic vascular compression syndromes, correlating with anatomical variants and to provide key features for the noninvasive imaging diagnosis.

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“…5) [13,14]. The definite prevalence of NCS is unclear due to the high variability in clinical manifestations [15,16]. Some anatomical variants may cause NCS.…”

Section: Nutcracker Syndromementioning

confidence: 99%

CT imaging findings of abdominopelvic vascular compression syndromes: what the radiologist needs to know

et al. 2020

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“…The following years saw the development and increase in the frequency of angiographic examinations in computed tomography and magnetic resonance imaging. [4,[21][22][23]. The first attempts were also made to standardize this type of research and to create the first classifications describing the phenomenon of pelvic venous insufficiency [4,[21][22][23].…”

Section: Introductionmentioning

confidence: 99%

“…[4,[21][22][23]. The first attempts were also made to standardize this type of research and to create the first classifications describing the phenomenon of pelvic venous insufficiency [4,[21][22][23]. In the newest international consensuses [24,25] the authors briefly present 4-grades (GI-GIV) of pelvic venous reflux criteria for cross-sectional imaging diagnosis of PVI.…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic and Radiological Classification of Ovarian Veins System Insufficiency

Szary

Wilczko²,

Zawadzki

et al. 2021

JCM

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Ovarian veins system insufficiency is one of the most common reasons for pelvic venous insufficiency (PVI). PVI is a hemodynamic phenomenon responsible for the occurrence of venous insufficiency of the lower extremities and recurrent varicose veins in nulliparous and parous women, as well as for a set of symptoms described as pelvic congestion syndrome (PCS). In the years 2017–2019, 535 patients admitted to our center with symptoms of venous insufficiency of the lower extremities, underwent complete ultrasound diagnostics (color-duplex ultrasound) of the venous system of the abdomen, pelvis and lower limbs, as well as extended imaging diagnostics using computed tomography (CT) or magnetic resonance (MR) venography. On the basis of the obtained results, the authors proposed a 4-grade hemodynamic and radiological classification (grades I-IV) defining the stratification of ovarian veins insufficiency. Using the above mentioned classification approx. 32% patients were identified as Grade I and I/II, approximately 35% revealed morphological and hemodynamic changes corresponding to Grade II and II/III, approximately 25% were classified as Grade III, whereas the remaining 8% were assessed as Grade IV. The described classification allows for the grading of ovarian veins insufficiency based on transparent radiological criteria, making it easy to use in everyday clinical practice. According to the authors, the proposed classification could facilitate communication between diagnostic physicians, specialists dealing with the treatment of venous insufficiency and gynecologists, who admit patients with symptoms suggesting venous insufficiency of the pelvis.

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“…Magnetic resonance imaging (MRI) provides excellent pelvic organ imaging and can be utilized for PVI detection. Although, it carries the risk of underestimation of the extent of the pelvic venous plexus and dilatation of the gonadal vein, when performed in dorsal decubitus, several studies showed its high sensitivity and specificity reaching 88-100% and 38-75%, respectively [2,18]. A comparable efficacy in the assessment of flow velocity and reflux in ovarian veins is observed in phase-contrast MRI.…”

Section: Diagnosismentioning

confidence: 99%

“…In summary, the most important imaging feature for the diagnosis of PVI is the demonstration of a reflux in one or both gonadal veins. Furthermore, the presence of a dilated vain which crosses the midline of the uterus seems to be the most specific sign of PVI [18]. The differential diagnosis of CPP could be long and trying as chronic pain is often the result of a multiple, overlapping pain condition, with each contributing to the generation of pain.…”

Section: Diagnosismentioning

confidence: 99%

Pelvic venous insufficiency — an often-forgotten cause of chronic pelvic pain

2020

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Imaging Appearance and Nonsurgical Management of Pelvic Venous Congestion Syndrome

Cited by 57 publications

References 45 publications

CT imaging findings of abdominopelvic vascular compression syndromes: what the radiologist needs to know

CT imaging findings of abdominopelvic vascular compression syndromes: what the radiologist needs to know

Hemodynamic and Radiological Classification of Ovarian Veins System Insufficiency

Pelvic venous insufficiency — an often-forgotten cause of chronic pelvic pain

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