Park et al identified findings on transabdominal and transvaginal sonography that are associated with the pelvic congestion syndrome. Congestion of pelvic veins may be associated with chronic pelvic pain in women. The authors are from Soonchunhyang University in Korea.
A woman with the pelvic congestion is often premenopausal and multiparous.
Ultrasonographic findings associated with the pelvic congestion syndrome:
(1) dilatation of the left ovarian vein with reversed caudal flow (especially when >= 8 mm in diameter)
(2) pelvic varicosities (multiple dilated veins around the ovaries and uterus with a diameter > 5 mm)
(3) dilated arcuate veins > 5 mm in diameter within the myometrium
(4) multiple cysts in bilaterally enlarged ovaries, often in clusters of 4-6 cysts ranging from 5 to 15 mm in diameter
(5) a variable duplex waveform and accentuation of the pelvic varicocele while the patient performs the Valsalva maneuver
The presence of multiple findings favors the diagnosis of the pelvic congestion syndrome.
Relief of pain following embolization of the dilated veins confirms the diagnosis.
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