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| Coronal thick slab MIP images showing dilated left gonadal vein reaching the renal vein. | 
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| Coronal thick slab MIP images showing unilateral pelvic varices on left side. | 
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| 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

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