Imaging Pearls ❯ Vascular ❯ Ovarian Vein
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- “Gonadal vein thrombosis can be seen in up to 80% of asymptomatic women who undergo routine CT after hysterectomy and lymphadenectomy for neoplasm. When acute, the central thrombus typically demonstrates low attenuation and is associated with mural enhancement. The vessel chronically becomes fibrotic and contracted, and phleboliths may develop.”
Managing Incidental Findings on Abdominal and Pelvic CT and MRI, Part 2: White Paper of the ACR Incidental Findings Committee II on Vascular Findings
Khosa F et al
J Am Coll Radiol. 2013 Oct;10(10):789-94
- “Ovarian veins originate from the plexus in the broad ligament near the ovary and fallopian tubes and communicate with the uterine plexus, then course anterior to the psoas muscle and the ureter. The right ovarian vein typically drains into the IVC and the left ovarian vein into the left renal vein. Autopsy studies have shown that valves are absent in the cranial portion of the ovarian vein in 15% of women on the left and 6% on the right . The valves are incompetent on either side in 35% to 43%, with a higher frequency in multiparous women, resulting in dilation >8 mm and incompetence in many asymptomatic patients who undergo CT.”
Managing Incidental Findings on Abdominal and Pelvic CT and MRI, Part 2: White Paper of the ACR Incidental Findings Committee II on Vascular Findings
Khosa F et al
J Am Coll Radiol. 2013 Oct;10(10):789-94 - “Incompetence of the ovarian and draining pelvic veins and venous reflux are considered the main cause of pelvic congestion syndrome in women, symptoms of which include persistent dull pelvic pain lasting >6 months, dysmenorrhea, dyspareunia, postcoital ache, and urinary symptoms. However, dilated pelvic veins are often seen incidentally in asymptomatic multiparous women . If dilated pelvic veins are noted in a woman and are asymptomatic, no further imaging or intervention is recommended..”
Managing Incidental Findings on Abdominal and Pelvic CT and MRI, Part 2: White Paper of the ACR Incidental Findings Committee II on Vascular Findings
Khosa F et al
J Am Coll Radiol. 2013 Oct;10(10):789-94
- Ovarian Vein Thrombosis: causes
- Pelvic inflammatory disease
- In oncology patients
- Complication of pelvic surgery
- Clinical symptoms range from vague pain to PE, sepsis or even death - Ovarian Vein: Facts
- Right ovarian vein drains into the IVC
- Left ovarian vein drains into the left renal vein
- Ovarian veins are 3-4 mm in size
- Ovarian vein is usually anterior to the ureter "Volume-rendered images and curved planar reformatted images can be used to show the ovarian veins. MDCT findings allow the diagnosis of various ovarian vein disorders in patients with abdominal and pelvic pain, pulmonary thromboembolism, and pelvic mass."
MDCT of the Ovarian Vein: Normal Anatomy and Pathology
Karaosmanoglu D et al.
AJR 2009; 192:295-299