Evaluating the frequency and severity of ovarian venous congestion on adult computed tomography

Diane Szaflarski, Eitan Sosner, Travis D. French, Samia Sayegh, Ramit Lamba, Douglas S. Katz, Jason C. Hoffmann

Research output: Contribution to journalArticle

Abstract

Purpose: While pelvic congestion syndrome and chronic pelvic pain are relatively common in women, no large- or medium-sized studies have been conducted to our knowledge to evaluate the frequency and severity of ovarian vein dilatation (OVD) on computed tomography (CT). The purpose of our study was therefore to analyze a large number of consecutive abdominal and pelvic CT scans in adult women to determine OVD frequency and severity. Methods: An IRB-approved, single-institution retrospective analysis of 1042 consecutive abdominal and pelvic CT scans in women ages 25–65 was performed. Scans were evaluated for the presence and severity of OVD and association with “nutcracker anatomy.” A gradation scheme was developed based on quartile analysis. Results: 143 of the CT scans had OVD (13.7%). Of the positive scans, 96 were bilateral, 29 were left-side only, 18 were right-side only, and 18 had nutcracker-type compression of the left renal vein (14.4% of scans with left or bilateral OVD). In positive scans, the mean and median left OVD were 7.5 and 7 mm, respectively, and right-side were 7.2 and 7 mm, respectively. Based on quartile analysis, OVD grading was mild (< 6 mm), moderate (6–8 mm), or severe (> 8 mm), with moderate including the middle 50% of patients. Conclusions: OVD was found on 13.7% of 1042 consecutive female abdominal and pelvic CT scans, with “nutcracker anatomy” present in 14.4% of the scans with left OVD. Moderate dilatation was defined as an OVD of 6–8 mm at the iliac crests.

Original languageEnglish (US)
JournalAbdominal Radiology
DOIs
StateAccepted/In press - Jan 1 2018

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Hyperemia
Dilatation
Veins
Tomography
Anatomy
Renal Veins
Pelvic Pain
Research Ethics Committees
Chronic Pain

Keywords

  • Computed tomography
  • Ovarian vein dilatation
  • Pelvic congestion syndrome

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

Cite this

Szaflarski, D., Sosner, E., French, T. D., Sayegh, S., Lamba, R., Katz, D. S., & Hoffmann, J. C. (Accepted/In press). Evaluating the frequency and severity of ovarian venous congestion on adult computed tomography. Abdominal Radiology. https://doi.org/10.1007/s00261-018-1707-9

Evaluating the frequency and severity of ovarian venous congestion on adult computed tomography. / Szaflarski, Diane; Sosner, Eitan; French, Travis D.; Sayegh, Samia; Lamba, Ramit; Katz, Douglas S.; Hoffmann, Jason C.

In: Abdominal Radiology, 01.01.2018.

Research output: Contribution to journalArticle

Szaflarski, Diane ; Sosner, Eitan ; French, Travis D. ; Sayegh, Samia ; Lamba, Ramit ; Katz, Douglas S. ; Hoffmann, Jason C. / Evaluating the frequency and severity of ovarian venous congestion on adult computed tomography. In: Abdominal Radiology. 2018.
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abstract = "Purpose: While pelvic congestion syndrome and chronic pelvic pain are relatively common in women, no large- or medium-sized studies have been conducted to our knowledge to evaluate the frequency and severity of ovarian vein dilatation (OVD) on computed tomography (CT). The purpose of our study was therefore to analyze a large number of consecutive abdominal and pelvic CT scans in adult women to determine OVD frequency and severity. Methods: An IRB-approved, single-institution retrospective analysis of 1042 consecutive abdominal and pelvic CT scans in women ages 25–65 was performed. Scans were evaluated for the presence and severity of OVD and association with “nutcracker anatomy.” A gradation scheme was developed based on quartile analysis. Results: 143 of the CT scans had OVD (13.7{\%}). Of the positive scans, 96 were bilateral, 29 were left-side only, 18 were right-side only, and 18 had nutcracker-type compression of the left renal vein (14.4{\%} of scans with left or bilateral OVD). In positive scans, the mean and median left OVD were 7.5 and 7 mm, respectively, and right-side were 7.2 and 7 mm, respectively. Based on quartile analysis, OVD grading was mild (< 6 mm), moderate (6–8 mm), or severe (> 8 mm), with moderate including the middle 50{\%} of patients. Conclusions: OVD was found on 13.7{\%} of 1042 consecutive female abdominal and pelvic CT scans, with “nutcracker anatomy” present in 14.4{\%} of the scans with left OVD. Moderate dilatation was defined as an OVD of 6–8 mm at the iliac crests.",
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AU - Lamba, Ramit

AU - Katz, Douglas S.

AU - Hoffmann, Jason C.

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N2 - Purpose: While pelvic congestion syndrome and chronic pelvic pain are relatively common in women, no large- or medium-sized studies have been conducted to our knowledge to evaluate the frequency and severity of ovarian vein dilatation (OVD) on computed tomography (CT). The purpose of our study was therefore to analyze a large number of consecutive abdominal and pelvic CT scans in adult women to determine OVD frequency and severity. Methods: An IRB-approved, single-institution retrospective analysis of 1042 consecutive abdominal and pelvic CT scans in women ages 25–65 was performed. Scans were evaluated for the presence and severity of OVD and association with “nutcracker anatomy.” A gradation scheme was developed based on quartile analysis. Results: 143 of the CT scans had OVD (13.7%). Of the positive scans, 96 were bilateral, 29 were left-side only, 18 were right-side only, and 18 had nutcracker-type compression of the left renal vein (14.4% of scans with left or bilateral OVD). In positive scans, the mean and median left OVD were 7.5 and 7 mm, respectively, and right-side were 7.2 and 7 mm, respectively. Based on quartile analysis, OVD grading was mild (< 6 mm), moderate (6–8 mm), or severe (> 8 mm), with moderate including the middle 50% of patients. Conclusions: OVD was found on 13.7% of 1042 consecutive female abdominal and pelvic CT scans, with “nutcracker anatomy” present in 14.4% of the scans with left OVD. Moderate dilatation was defined as an OVD of 6–8 mm at the iliac crests.

AB - Purpose: While pelvic congestion syndrome and chronic pelvic pain are relatively common in women, no large- or medium-sized studies have been conducted to our knowledge to evaluate the frequency and severity of ovarian vein dilatation (OVD) on computed tomography (CT). The purpose of our study was therefore to analyze a large number of consecutive abdominal and pelvic CT scans in adult women to determine OVD frequency and severity. Methods: An IRB-approved, single-institution retrospective analysis of 1042 consecutive abdominal and pelvic CT scans in women ages 25–65 was performed. Scans were evaluated for the presence and severity of OVD and association with “nutcracker anatomy.” A gradation scheme was developed based on quartile analysis. Results: 143 of the CT scans had OVD (13.7%). Of the positive scans, 96 were bilateral, 29 were left-side only, 18 were right-side only, and 18 had nutcracker-type compression of the left renal vein (14.4% of scans with left or bilateral OVD). In positive scans, the mean and median left OVD were 7.5 and 7 mm, respectively, and right-side were 7.2 and 7 mm, respectively. Based on quartile analysis, OVD grading was mild (< 6 mm), moderate (6–8 mm), or severe (> 8 mm), with moderate including the middle 50% of patients. Conclusions: OVD was found on 13.7% of 1042 consecutive female abdominal and pelvic CT scans, with “nutcracker anatomy” present in 14.4% of the scans with left OVD. Moderate dilatation was defined as an OVD of 6–8 mm at the iliac crests.

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KW - Ovarian vein dilatation

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