Role of duplex color Doppler ultrasound, computed tomography, and MR angiography in the diagnosis of septic puerperal ovarian vein thrombosis

Abstract

MRA is recommended in all patients with inconclusive CDUS findings and persistent suspicion for SPOVT. CT has the advantage of more rapid access and lower cost and thus will probably remain a sufficiently accurate alternative. Septic puerperal ovarian vein thrombosis (SPOVT)-Computed tomography-Magnetic resonance angiography-Ultrasound.

Ovarian vein thrombosis in the nonpregnant woman: an overlooked diagnosis

“…CT scan with intravenous contrast enhancement has a sensitivity of 77.8% and specificity of 62.5%. Color Doppler ultrasound has the lowest sensitivity of 55.6% and a specificity of 41.5% among other imaging modalities [Kubik-Huch et al 1999].…”

Added value of diffusion weighted MRI in the diagnosis of postpartum ovarian vein thrombosis

“…thrombus extension into the inferior vena cava or renal veins, sepsis and septic pulmonary embolism are all potentially life threatening. In the United States, POVT is estimated to cause 18 maternal deaths per million pregnancies.POVT involves the right ovarian vein in 80-90% of patients (2,3). Ultrasound and color-Doppler may show a tubular anechoic to hypoechoic structure extending superiorly from the adnex and with absence of central Doppler flow (2, 4).…”

Postpartum Ovarian Vein Thrombosis: An Update

“…The sensitivity of ultrasound was only 55.6% with a specificity of 41.2%. CT imaging was better with a sensitivity of 77.8% and a specificity of 62.5%; MRI with MRA was clearly superior with 100% sensitivity and specificity (11). Although the sensitivity and specificity of MRI may be similar to or better than CT, the latter is often the imaging modality of choice because it is more readily available at most institutions.…”