Rezaei-Kalantari Kiara, Fahrni Guillaume, Rotzinger David C, Qanadli Salah D
Department of Radiology, Rajaie Cardiovascular, Medical and Research Center, Cardio-Oncology Research Center, Iran University of Medical Sciences, Tehran, Iran.
Department of Diagnostic and Interventional Radiology, Cardiothoracic and Vascular Division, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Front Cardiovasc Med. 2023 Jan 19;10:1102063. doi: 10.3389/fcvm.2023.1102063. eCollection 2023.
Pelvic venous disorders (PeVD), sometimes referred to as pelvic congestion syndrome (PCS), widely impact affected patients-mainly young women's quality of life, causing puzzling, uncomfortable symptoms sometimes requiring months or years to get an explanation, while simply remaining undiagnosed in other cases. Because pelvic pain is a non-specific symptom, an appropriate diagnosis requires a careful patient workup, including a correlation between history and non-invasive imaging. Invasive imaging is frequently required to confirm the diagnosis and plan treatment. Current therapeutic approaches principally rely on minimally invasive techniques delivered through endovascular access. However, while comprehensive descriptive classifications such as the symptoms-varices-pathophysiology (SVP) classification exist, universally accepted guidelines regarding therapy to apply for each SVP category are still lacking. This review strongly focuses on PeVD imaging and discusses available therapeutic approaches with regard to pathophysiological mechanisms. It proposes a new classification scheme assisting clinical decision-making about endovascular management to help standardize the link between imaging findings and treatment.
盆腔静脉疾病（PeVD），有时也被称为盆腔淤血综合征（PCS），广泛影响着受其困扰的患者——主要是年轻女性的生活质量，引发令人困惑的不适症状，有时需要数月或数年才能找到病因，而在其他情况下则根本无法确诊。由于盆腔疼痛是一种非特异性症状，因此准确诊断需要对患者进行细致的检查，包括病史与非侵入性成像之间的关联。通常需要进行侵入性成像来确诊并制定治疗方案。目前的治疗方法主要依赖通过血管内介入的微创技术。然而，尽管存在诸如症状-静脉曲张-病理生理学（SVP）分类等全面的描述性分类，但针对每个SVP类别应用何种治疗方法的普遍接受的指南仍然缺失。本综述着重聚焦于PeVD成像，并根据病理生理机制讨论了现有的治疗方法。它提出了一种新的分类方案，以协助关于血管内治疗的临床决策，帮助规范成像结果与治疗之间的联系。
