Ovarian vein diameters measured by MDCT in women without evidence of pelvic congestion syndrome

Abstract

Abstract:Objectives: The purpose of this study was to clarify reference values for ovarian veins diameters in women without evidence of primary or secondary pelvic venous insufficiency and to determine factors influencing these parameters. Methods: Multidetector computed tomography images and medical records of 197 women were retrospectively reviewed. The patients' age, body mass index and history of parturition were examined. Results: Diameters of right ovarian veins (ROV) and left ovarian veins (LOV) ranged from one to six mm (mean 2.9 (1.0) mm, 3.2 (1.2) mm, respectively). The reference values for ROVs diameters were between 0.9 mm and 4.9 mm (95% CI 2.7-3.0 mm), while the reference values for LOVs diameters ranged from 0.8 mm to 5.5 mm (95% CI 3.0-3.3 mm). ROV diameter was significantly narrower than LOV diameter (2.9 (1.0) vs 3.2 (1.2) mm, p=0.031). Ovarian veins diameters were smaller in elderly patients (p=0.001 and p=0.002), and larger in nulliparous women (p=0.002) and those with higher individual frequency of parturition (p=0.05). There was a tendency to higher values of veins size in presence of drainage variation. Multiple regression analysis revealed presence of negative significant relationship of ROV size with age, positive association with parturition frequency and anatomical drainage variation of ovarian veins. ROVs and LOVs diameters did not differ in subgroups of normal weight, overweight and obese patients (p>0.05). Conclusions:The present study demonstrated significant reduction of ovarian veins diameters with advancement in age of patients, while increased ovarian veins diameters were related positively to parturition history and higher parturition frequency index. There was a negative relationship of right ovarian veins size with age, and positive association with parturition frequency and drainage variation. Only individual parturition frequency had an independent association with left ovarian vein diameter.

A cadaveric study of ovarian veins: variations, measurements and clinical significance

“…In current study, our findings (mean right and left ovarian venous diameter, 3.66 mm and 4.20 mm, respectively) fall in range with previous study-findings. We found relatively higher diameters in left ovarian veins similar to some previous studies [9,19] which was found to be statisti-cally significant (P<0.05). It could be due to natural anatomical factors which make the left gonadal vein more vulnerable to congestion and dilatation [2].…”

“…In a study by Pavkov et al [20] on plastinated cadavers, the mean diameter of ovarian veins was 3.49 mm; in our study it was 3.93 mm. A multi-detector computed tomography based study [9] showed the mean right and left ovarian venous diameters as 2.9 and 3.2 mm, respectively. Another CT based study by Nascimento et al [18] showed the average diameters were 4.4 mm and 4.5-6.5 mm in right and left ovarian veins, respectively.…”

“…During renal transplant surgeries the donor gonadal vein is often utilized for vascular reconstruction [5][6][7]. It is suspected that some variations of the gonadal venous drainage pattern could induce hemodynamic differences causing gonadal venous congestion [8]; reflux in incompetent and dilated ovarian vein may cause pelvic congestion [1,9].…”

“…On the other hand, the diagnosis of pelvic congestion syndrome and left renal vein compression syndrome in women are relatively difficult to diagnose as there are no gold standard techniquesduplex ultrasound is not much helpful, catheter based intravenous pressure measurement is too expensive for a routine use, only measurement of venous diameter could be of some help [2]. Very few researchers have measured and reported the diameters of ovarian veins [9,18].…”

Pelvic venous insufficiency: Lipid peroxidation levels in ovarian venous blood

“…On the left, the ovarian vein flows into the left renal vein; on the right, however, the ovarian vein flows directly into the inferior vena cava. All pelvic venous plexuses anastomose with one other, and these anastomoses vary considerably in their flow capacity 22 . A number of studies have reported the significance of anatomy in PVI, which occurs frequently in the left ovarian vein 23 .…”