MDCT of the Ovarian Vein: Normal Anatomy and Pathology

Karaosmanoğlu, Devrim; Karçaaltıncaba, Muşturay; Karçaaltıncaba, Deniz; Akata, Deniz; Ozmen, Mustafa

doi:10.2214/ajr.08.1015

Cited by 66 publications

(56 citation statements)

References 16 publications

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“…A gonadal vein was considered dilated if it measured greater than 5 mm in diameter. 12,13 A lumbar vein communicating with the left renal vein was considered dilated if it measured greater than 3 mm in diameter, 14 based on published standards in the literature. Hematuria was considered present if microscopic, greater than 3 red blood cells per high-powered field, or macroscopic.…”

Section: Discussionmentioning

confidence: 99%

Incidental Detection of Nutcracker Phenomenon on Multidetector CT in an Asymptomatic Population

Grimm

Engstrom

Nelson

et al. 2013

Journal of Computer Assisted Tomography

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Section: Discussionmentioning

confidence: 99%

Incidental Detection of Nutcracker Phenomenon on Multidetector CT in an Asymptomatic Population

Grimm

Engstrom

Nelson

et al. 2013

Journal of Computer Assisted Tomography

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“…Both ovarian veins ascend anterior to the psoas muscle and the ureters. The right ovarian vein drains into the inferior vena cava in the majority of women, although, in up to 10% of women, it may also drain into the right renal vein 4. The left ovarian vein drains into the left renal vein in most women.…”

Section: Normal Anatomymentioning

confidence: 99%

“…The normal venous plexus appears as one or two straight tubular structures12 with a normal diameter of <4 mm 4. In PCS, US shows multiple dilated veins around the ovary and uterus (diameter >6 mm) 7.…”

Section: Diagnostic Imagingmentioning

confidence: 99%

Pelvic congestion syndrome: the role of interventional radiology in the treatment of chronic pelvic pain

Freedman

Ganeshan

Crowe

2010

Postgraduate Medical Journal

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Chronic pelvic pain is a common problem for female patients and is defined as pain that has been present for 6 months or more. Chronic pelvic pain with associated ovarian vein varicosities is termed pelvic congestion syndrome (PCS) and is an important but under-diagnosed condition. The aetiology of pelvic varicosities is reflux of blood in the ovarian veins due to the absence of functioning valves, resulting in retrograde blood flow and eventual venous dilatation. The cardinal presenting symptom of PCS is pelvic pain, usually described as a dull ache, without evidence of inflammatory disease. Clinical signs may include vulval varicosities extending on to the medial thigh and long saphenous territory as well as tenderness on deep palpation at the ovarian point; however, such signs are not always present. Non-invasive imaging (ultrasound, CT and magnetic resonance venography) plays a central role in establishing the diagnosis, excluding alternative causes of pelvic pain and providing a road map for novel minimally invasive treatment options that are now available. Day-case percutaneous-directed venous embolisation is now accepted as a valuable treatment option for PCS with promising results from early clinical trials and is fast becoming the first-line treatment option for this condition. This paper aims to raise awareness of PCS among clinicians and reviews the pathogenesis, imaging assessment and minimally invasive treatment options that are now available.

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“…Pelvic US (transabdominal or transvaginal) is often the first-line examination (10,11). With CT, the tubular structure of dilated ovarian veins and the pattern of their enhancement after intravenous administration of contrast medium allow the investigator to distinguish them from adnexal masses or lymphadenopathy (12,13). MRI is the preferred noninvasive modality because it avoids radiation, and allows a complete evaluation of the pelvic anatomy due to its multiplanar capability (14).…”

Section: Discussionmentioning

confidence: 99%

Pregnancy after embolization of ovarian varicocele: report of two cases

Таразов

Prozorovskij²,

Rumiantseva³

2009

Diagn Interv Radiol

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Ovarian varicocele is a well-known cause of pelvic pain in women (1-3). Surgical or laparoscopic ligation, or retrograde transcatheter embolization is successfully used for treatment of symptomatic cases (l-6).In 1991, Galkin et al. (7) hypothesized that long-lasting ovarian varicocele might cause hypofunction of the ovaries and, similar to testicular varicocele, could be a cause of infertility. This hypothesis is not yet proven in the medical literature. We report two cases of pregnancy in women with infertility after successful transcatheter embolization of ovarian varices. Case reports Case 1A 43-year-old woman presented with chronic pelvic pain of three years duration. Her pain increased after physical activity and during menses. She had given birth to a full-term baby 20 years prior to presentation. She has not become pregnant since that time, despite a lack of contraception during the last 7 years. Repeated gynecologic examinations including hysterosalpingography did not reveal any source of pelvic pain. No disorder of hormonal milieu was noted on endocrine evaluation.Abdominal ultrasound did not reveal any gynecologic pathology such as leiomyoma, adenomyosis, or endometriosis, but it showed marked dilatation of veins around the left ovary. The diameter of the left ovarian vein trunk was 12 mm.The presence of left ovarian varicocele was confirmed by selective retrograde venography. The right transjugular approach was used, because the patient had several large moles on both groins. A Headhunter 1 catheter (Cordis, Bridgewater, New Jersey, USA) was placed in the left renal vein, and then in the left ovarian vein. Embolization of the dilated left ovarian vein was performed with three long and four short homemade steel coils 10-12 mm in diameter (Fig. 1). The right ovarian vein was not dilated.During the next month, the patient had significant reduction of pelvic pain, which eventually disappeared completely. Ultrasound (US) examination showed occlusion and fibrosis of the left ovarian vein, and disappearance of pelvic varices. Three months after the procedure, the patient became pregnant. The pregnancy was normal, and resulted in an easy delivery. Case 2A 25-year-old woman was referred to our hospital with a 4-year history of infertility. She had never been pregnant. She complained of periodic mild pelvic pain and dysmenorrhea. Her symptoms were aggravated by standing for a long time, and they increased during sexual activity. No pathological changes were observed on gynecologic examination or en- ABSTRACT We describe two cases of left-sided ovarian varicocele in patients with infertility. Pregnancy occurred in both women after successful retrograde venous embolization. Ovarian varicocele may be associated with infertility in some patients. INTERVENTIONAL RADIOLOGY

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MDCT of the Ovarian Vein: Normal Anatomy and Pathology

Abstract: Volume-rendered images and curved planar reformatted images can be used to show the ovarian veins. MDCT findings allow the diagnosis of various ovarian vein disorders in patients with abdominal and pelvic pain, pulmonary thromboembolism, and pelvic mass.

Cited by 66 publications

References 16 publications

Incidental Detection of Nutcracker Phenomenon on Multidetector CT in an Asymptomatic Population

Incidental Detection of Nutcracker Phenomenon on Multidetector CT in an Asymptomatic Population

Pelvic congestion syndrome: the role of interventional radiology in the treatment of chronic pelvic pain

Pregnancy after embolization of ovarian varicocele: report of two cases

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