Department of Radiology and Vascular Surgery, Imperial College NHS Trust, St Mary's Hospital, Praed St, London W2 1NY, UK.
Br J Radiol. 2010 Oct;83(994):882-7. doi: 10.1259/bjr/82417499.
The purpose of this study was to assess the role of magnetic resonance venography (MRV) with time-resolved imaging of contrast kinetics (TRICKS) in dynamically evaluating ovarian vein dilation, reflux and direction of flow in patients with suspected pelvic congestion syndrome (PCS). The hypotheses tested were: (i) That conspicuity scores of the ovarian veins across three raters was greater using TRICKS MRV compared with T2W or T(2)* imaging; (ii) That three key MR variables (ovarian vein diameter, timing and grade of reflux) correlated across all raters. We carried out a retrospective study of 13 patients undergoing T2W and TRICKS MRI and pelvic sonography (n = 4) or catheter venography (n = 5). Three observers rated conspicuity, vessel diameter, timing and grade of ovarian vein reflux for T(2)/T2W and TRICKS MRI. The mean left ovarian diameter for all patients with reflux was 7.9 mm (range 2.2-12 mm). There was high inter-observer agreement for ovarian vein diameter for both sequences. TRICKS showed significantly greater conspicuity than T(2)/T2W imaging (TRICKS: T(2)/T2* mean (SD) = 7.80 (3.20):5.50 (1.97), F (1,12) = 5.80, p < 0.05). TRICKS MRV demonstrated high inter-observer correlation for timing and grade of reflux (r (36) = 0.77,0.71,0.79, p < 0.01). TRICKS MRA/V was significantly degraded by breathing artefact in two patients. We conclude that TRICKS MRV accurately and dynamically demonstrates ovarian vein reflux in patients with PCS but requires quiet respiration. TRICKS MRV has better image conspicuity than T(2)/T2*W imaging and sufficient temporal resolution to distinguish between Grade I, II and III reflux.
本研究旨在评估磁共振静脉造影（MRV）与对比动力学时间分辨成像（TRICKS）在动态评估疑似盆腔淤血综合征（PCS）患者卵巢静脉扩张、反流和血流方向中的作用。测试的假设为：（i）与 T2W 或 T（2）成像相比，使用 TRICKS MRV 时三位评估者对卵巢静脉的显影评分更高；（ii）所有评估者之间的三个关键 MR 变量（卵巢静脉直径、时间和反流程度）均相关。我们对 13 例接受 T2W 和 TRICKS MRI 及盆腔超声（n = 4）或导管静脉造影（n = 5）检查的患者进行了回顾性研究。三位观察者对 T（2）/T2W 和 TRICKS MRI 的卵巢静脉显影、血管直径、时间和反流程度进行了评分。所有有反流的患者的左侧卵巢平均直径为 7.9mm（范围 2.2-12mm）。两种序列的卵巢静脉直径的观察者间一致性均较高。TRICKS 比 T（2）/T2W 成像显示出显著更高的显影（TRICKS：T（2）/T2平均（SD）= 7.80（3.20）：5.50（1.97），F（1,12）= 5.80，p < 0.05）。TRICKS MRV 显示出时间和反流程度的观察者间高度相关性（r（36）= 0.77、0.71、0.79，p < 0.01）。两名患者因呼吸伪影导致 TRICKS MRA/V 显著降级。我们的结论是，TRICKS MRV 可准确、动态地显示 PCS 患者的卵巢静脉反流，但需要安静呼吸。TRICKS MRV 的图像显影优于 T（2）/T2*W 成像，且具有足够的时间分辨率，可以区分 I 级、II 级和 III 级反流。
