Pelvic congestion syndrome: demonstration and diagnosis by helical CT

Desimpelaere, J.; Seynaeve, Patrick; Hagers, Yves; Appel, B.; Mortelmans, L. L.

doi:10.1007/s002619900451

Cited by 59 publications

(35 citation statements)

References 6 publications

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“…In our study, the mean diameter of the left ovarian vein was 7.8¡1.2 mm (range 5.2-9.7 mm) on TR-MRA. Our results are similar to those of previous studies [9,10,20]. The mean diameter of the left ovarian vein was 9.2¡1.7 mm (range 5.7-11.7 mm) on conventional venography in our study.…”

Section: Time-resolved Mr Angiography On Ovarian Venous Refluxsupporting

confidence: 83%

“…The normal range of diameters of competent left ovarian veins is between 3.2 mm and 3.6 mm [4,21,22]. The diameter of the ovarian veins in patients with pelvic congestion syndrome on sonography or CT is between 7 mm and 8 mm [6,9,10,20]. In our study, the mean diameter of the left ovarian vein was 7.8¡1.2 mm (range 5.2-9.7 mm) on TR-MRA.…”

Section: Time-resolved Mr Angiography On Ovarian Venous Refluxmentioning

confidence: 80%

“…The scanning delay time of the CT examination is 20 or 30 s for a single-detector helical scanner [20] and 65-95 s for an 8-detector scanner [19]. Although CT may demonstrate the retrograde ovarian vein flow and it may exclude other pelvic pathologies that may be the cause of [11].…”

Section: Time-resolved Mr Angiography On Ovarian Venous Refluxmentioning

confidence: 99%

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Time-resolved MR angiography for detecting and grading ovarian venous reflux: comparison with conventional venography

Yang¹,

Kim²,

Nam³

et al. 2012

BJR

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Objective: The purpose of this study was to compare the diagnostic accuracy of timeresolved MR angiography (TR-MRA) with that of conventional venography for the detection and grading of ovarian venous reflux, which aid in the diagnosis of pelvic venous congestion. Methods: We performed a retrospective analysis of 19 consecutive patients who underwent TR-MRA and conventional venography. The images were analysed by two radiologists in a randomised ''blinded'' manner. With the use of conventional venography as a gold standard, the images were reviewed to determine if differences in the detection and grading of ovarian venous reflux were seen between TR-MRA and conventional venography; the sensitivity, specificity and accuracy of TR-MRA compared with that of conventional venography were evaluated. The McNemar test was performed to determine the significance of any differences. Interobserver agreement was analysed using generalised k statistics. Results: There was no significant difference between TR-MRA and conventional venography for grading ovarian venous reflux (p.0.05). The sensitivity, specificity and diagnostic accuracy of TR-MRA were found to be 66.7%, 100% and 78.9%, and 75%, 100% and 84.2%, respectively, for the two observers. The weighted k-values indicated excellent agreement between the two observers for grading ovarian venous reflux on TR-MRA (k50.894). Conclusion: TR-MRA is an accurate method for accessing pelvic venous congestion.

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Section: Time-resolved Mr Angiography On Ovarian Venous Refluxsupporting

confidence: 83%

Section: Time-resolved Mr Angiography On Ovarian Venous Refluxmentioning

confidence: 80%

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Time-resolved MR angiography for detecting and grading ovarian venous reflux: comparison with conventional venography

Yang¹,

Kim²,

Nam³

et al. 2012

BJR

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“…With CT, the tubular nature of these structures and the pattern of enhancement after intravenous contrast medium administration distinguish them from lymphadenopathy or adnexal masses [6]. Unlike such masses, pelvic varices appear isodense with other veins after contrast enhancement [7].Contrast-enhanced CT data as part of the combined PET/ CT examination provide additional information when compared with non-enhanced PET/CT. Because CT data supply the anatomic background for PET, the most important benefit relates to more precise anatomic localization of pathology by differentiation of the lesion from its surrounding structures [8].…”

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confidence: 99%

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confidence: 99%

Pelvic Congestion Syndrome Initially Detected by Contrast-Enhanced F-18 FDG-PET/CT

Kim

et al. 2012

Nucl Med Mol Imaging

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Pelvic congestion syndrome (PCS) is said to occur as a result of retrograde flow in an incompetent ovarian vein. Ovarian vein incompetence is seen in approximately 10 % of women, and up to 60 % with this abnormality can develop PCS [1]. The etiology of PCS is poorly understood and is likely to be multifactorial. Absence of ovarian vein valves is an important factor in its development [2]. The causes of ovarian varicoceles are multifactorial, involving both mechanical and hormonal factors. Dilatation of the ovarian veins can result in vascular incompetence and retrograde blood flow [3].On either CT or magnetic resonance (MR) imaging studies, pelvic varices in PCS appear as dilated, tortuous, enhancing tubular structures near the ovaries and uterus [4]. In addition, the extension of varices to the broad ligament and paravaginal venous plexus can be appreciated [5]. With CT, the tubular nature of these structures and the pattern of enhancement after intravenous contrast medium administration distinguish them from lymphadenopathy or adnexal masses [6]. Unlike such masses, pelvic varices appear isodense with other veins after contrast enhancement [7].Contrast-enhanced CT data as part of the combined PET/ CT examination provide additional information when compared with non-enhanced PET/CT. Because CT data supply the anatomic background for PET, the most important benefit relates to more precise anatomic localization of pathology by differentiation of the lesion from its surrounding structures [8]. By supporting lesion detection and characterization, CT contrast agents can be of additional value in F-18 FDG non-avid disease [9]. As in the presented case, careful review of CT images in contrastenhanced PET/CT enables the detection of F-18 FDG nonavid disease such as PCS (Fig. 1). As contrast-enhanced F-18 FDG PET/CT had been performed frequently, being familiar with the findings of PCS on the contrast-enhanced CT images would have been helpful for the nuclear medicine physicians.

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