Park Seong Jin, Lim Joo Won, Ko Young Tae, Lee Dong Ho, Yoon Yup, Oh Joo Hyoung, Lee Hae Kyung, Huh Chu Yeop
Department of Radiology, Soonchunhyang University Bucheon Hospital, 1174, Jung-dong, Wonmi-gu, Gyeonggi-do 420-021, Republic of Korea.
AJR Am J Roentgenol. 2004 Mar;182(3):683-8. doi: 10.2214/ajr.182.3.1820683.
We prospectively evaluated transabdominal and transvaginal sonographic findings of patients with pelvic congestion syndrome and compared them with those of healthy volunteers. SUBJECTS AND METHODS. We examined 32 patients with pelvic congestion syndrome and 35 control subjects. Using transabdominal sonography, we evaluated the ovarian veins for diameter and flow direction, presence of pelvic varicocele, diameter of the pelvic veins, change of the duplex waveform during the Valsalva's maneuver, volume of the uterus, and presence of polycystic changes in the ovaries. We compared and statistically analyzed each parameter in the pelvic congestion syndrome group and in the control group.
The mean (+/- SD) diameter of the left ovarian vein was 0.79 +/- 0.23 cm in the pelvic congestion syndrome group and 0.49 +/- 0.15 cm in the control group (p = 0.000). Reversed caudal flow in the left ovarian vein was present in 22 of 22 patients and in four of 16 control subjects. Pelvic varicoceles were present in all patients with pelvic congestion syndrome and in six control subjects. The mean diameter of the left pelvic vein was 0.68 +/- 0.21 cm in the pelvic congestion syndrome group and 0.42 +/- 0.19 cm in the control group; the mean diameter of the right pelvic vein was 0.64 +/- 0.24 cm in the pelvic congestion syndrome group and 0.35 +/- 0.14 cm in the control group (p = 0.000). Polycystic changes of the ovary were present in 13 patients with pelvic congestion syndrome (40.6%) and four control subjects (11.4%).
Sonographic findings of pelvic congestion syndrome were dilated left ovarian vein with reversed caudal flow, presence of varicocele, dilated arcuate veins crossing the uterine myometrium, polycystic changes of the ovary, and variable duplex waveform during the Valsalva's maneuver. Combined transabdominal and transvaginal sonography are potentially useful as a noninvasive screening tool for determining which patients with chronic pelvic pain may benefit from selective ovarian venography and transcatheter embolization.
我们前瞻性地评估了盆腔淤血综合征患者经腹和经阴道超声检查结果，并将其与健康志愿者的结果进行比较。
我们检查了32例盆腔淤血综合征患者和35例对照者。使用经腹超声，我们评估了卵巢静脉的直径和血流方向、盆腔静脉曲张的存在情况、盆腔静脉的直径、瓦尔萨尔瓦动作期间双功波形的变化、子宫体积以及卵巢多囊性改变的存在情况。我们对盆腔淤血综合征组和对照组的每个参数进行了比较和统计分析。
盆腔淤血综合征组左卵巢静脉的平均（±标准差）直径为0.79±0.23cm，对照组为0.49±0.15cm（p = 0.000）。22例盆腔淤血综合征患者中有22例左卵巢静脉出现反向尾向血流，16例对照者中有4例出现。所有盆腔淤血综合征患者均存在盆腔静脉曲张，6例对照者也存在。盆腔淤血综合征组左盆腔静脉的平均直径为0.68±0.21cm，对照组为0.42±0.19cm；盆腔淤血综合征组右盆腔静脉的平均直径为0.64±0.24cm，对照组为0.35±0.14cm（p = 0.000）。13例盆腔淤血综合征患者（40.6%）和4例对照者（11.4%）存在卵巢多囊性改变。
盆腔淤血综合征的超声检查结果为左卵巢静脉扩张伴反向尾向血流、静脉曲张的存在、穿过子宫肌层的弓形静脉扩张、卵巢多囊性改变以及瓦尔萨尔瓦动作期间双功波形变化。经腹和经阴道联合超声检查作为一种无创筛查工具，对于确定哪些慢性盆腔疼痛患者可能从选择性卵巢静脉造影和经导管栓塞中获益具有潜在的应用价值。
