Thursday, 6 December 2012


Coronal thick slab MIP images showing
dilated left gonadal vein reaching the renal vein.

Coronal thick slab MIP images showing unilateral pelvic varices on left side.

Volume rendered images(posterior view) showing
engorged left gonadal vein and ipsilateral pelvic varices.


·        In grade I, retrograde flow remained in the left ovarian vein, not reaching the parauterine veins.

·        In grade II, the retrograde flow advanced into the ipsilateral parauterine veins and no farther.

·        Finally, in grade III, the retrograde flow crossed the midline passing through the uterus from the left into the right parauterine plexus.

·        The flow-pathway was assessed from the level of the kidneys to the pelvic floor.

Causes :- 

·        Dilated and tortuous ovarian veins secondary to retrograde flow through incompetent valves

·        Obstructing anatomic anomalies

§  Retroaortic left renal vein

§  Left ovarian vein congestion due to compression of the left renal vein by the superior mesenteric artery (nutcracker phenomenon)

§  Right common iliac vein compression

§  Secondary congestion can be seen in various disorders including:

·        Valvular incompetence

·        Portal hypertension

·        Acquired inferior vena cava syndrome

 Reference : Reflux in the Left Ovarian Vein: Analysis of MDCT Findings in Asymptomatic Women, AJR November 2004 vol. 183 no. 5 1411-1415.

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