title: Transvaginal power Doppler ultrasound in pelvic congestion.
abstract: OBJECTIVE
  Pelvic congestion is diagnosed by transuterine venography, an invasive procedure requiring sedation and irradiation. Ultrasound may be an alternative but is hindered by slow flow within pelvic veins. In an attempt to counter this, we investigated the possible role of transvaginal power Doppler ultrasound.
  
  
  METHODS
  42 women with a clinical suspicion of pelvic congestion underwent transvaginal ultrasound. Adnexal veins were examined and a congestion score established. Planimetric measurements of adnexal vessels were obtained using power Doppler ultrasound, and uterine and ovarian morphology noted. All women then underwent transuterine venography and agreement with the ultrasound congestion score and morphologic features was determined.
  
  
  RESULTS
  There was a trend towards weak positive correlation between ultrasound and venography congestion scores (r = 0.29, p = 0.06). However, agreement between scores was poor on an individual basis (95% limits of agreement, -3.9 to +2.7). Planimetric power Doppler assessments of adnexal vascularity were unrelated to venographic congestion. Instead, there was correlation between the number and diameter of ovarian follicles and venographic congestion: women with congestion tended to have significantly more (0.04) and smaller follicles (p = 0.001).
  
  
  CONCLUSIONS
  There was poor individual agreement between ultrasound and venographic estimates of congestion. However, there was a direct relationship between venographic congestion score and ovarian morphology.
authors.affiliation: Intestinal Imaging Centre, St. Mark's Hospital, Middlesex, United Kingdom.
authors.forename: D
authors.initials: D
authors.lastname: Campbell
authors.forename: S
authors.initials: S
authors.lastname: Halligan
authors.forename: C I
authors.initials: CI
authors.lastname: Bartram
authors.forename: V
authors.initials: V
authors.lastname: Rogers
authors.forename: N
authors.initials: N
authors.lastname: Hollings
authors.forename: K
authors.initials: K
authors.lastname: Kingston
authors.forename: A
authors.initials: A
authors.lastname: Sahdev
authors.forename: R W
authors.initials: RW
authors.lastname: Beard
mesh_terms: D000290:Adnexa Uteri / Q000098:blood supply; D000328:Adult; D000465:Algorithms; D005260:Female; D006801:Humans; D010053:Ovary / Q000098:blood supply; D017699:Pelvic Pain / Q000000981:diagnostic imaging / Q000209:etiology*; D010388:Pelvis / Q000098:blood supply; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging*; D010690:Phlebography; D011446:Prospective Studies; D018608:Ultrasonography, Doppler