Diagnostic imaging of pelvic congestive syndrome.
Many female patients are affected by chronic pelvic pain and a significant number of referrals to the gynecology department result in a clinical suspicion of pelvic congestion syndrome. Additionally, patients referred to the vascular surgery department for venous disease can also present with complaints of a persistent dull lower abdominal pain in addition to typically distributed leg varicosities (that extend from the leg through the pelvic floor) which should be evaluated for the presence of pelvic congestion syndrome. In this article, we focus on imaging pelvic vein insufficiency and related (extending) varicosities: how should we evaluate the pelvic veins, what are the signs to look for, and what are the currently established criteria for (pre-interventional) imaging.
Department of Radiology and Interventional Radiology, Maastricht University Medical Centre, Maastricht, The Netherlands Department of Radiology and Interventional Radiology, VieCuri Medical Centre, Venlo, The Netherlands carnoldussen@viecuri.nl.
C W K P
CW
Arnoldussen
Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
M A F
MA
de Wolf
Department of Vascular Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands Department of Vascular Surgery, University Hospital Aachen, Aachen, Germany.
C H A
CH
Wittens
D005260:Female; D006801:Humans; D006940:Hyperemia / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D017699:Pelvic Pain / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D013577:Syndrome; D014689:Venous Insufficiency / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy
CT venography; MR venography; Pelvic congestive syndrome; embolization; trans-vaginal ultrasound; ultrasound