Li Chen-Yu, Chen Chien-Wei, Kao Chih-Chen, Hsu Yin-Chen, Lee Chung-Yuan, Lin Chieh-Chao, Yang Teng-Yao, Wang Shih-Chung, Chen Sheng-Ya, Lin Yu-Hui, Wong Min Yi, Chang Chee-Jen, Huang Yao-Kuang
Department of Finance, National Taichung University of Science and Technology, Taichung.
Department of Diagnostic Radiology, ChiaYi Chang Gung Memorial Hospital, Chiayi.
Int J Surg. 2024 Oct 1;110(10):6470-6483. doi: 10.1097/JS9.0000000000001810.
To examine the application of quantitative 2-dimensional phase-contrast MRI (2D PC-MRI) for treating patients with pelvic congestion syndrome (PCS).
The authors conducted a retrospective cross-sectional analysis by using quantitative 2D PC-MRI data enrolled between April 2017 and September 2023. In addition, 32 healthy female controls (HCs) were included.
Most patients with PCS presented with chronic pelvic pain and more than half had extrapelvic venous symptoms (80/81, 98% and 45/81, 56%, respectively). Quantitative 2D PC-MRI analyzed the 81 patients with PCS, 239 patients without PCS, and 32 HCs. The patients with PCS had higher stroke volume (SV), absolute SV (ASV), and mean flux (MF) in the calf region (interstitial pixel shift) than did the HCs. In the left gonadal vein, the patients with PCS had higher SV, backward flow volume (BFV), ASV, and MF and lower forward flow volume (FFV), stroke distance (SD), and mean velocity (MV) than did the HCs. However, the patients with PCS had lower SV, FFV, MF, SD, and MV in the great saphenous veins. Quantitative 2D PC-MRI analysis revealed that the PCS group had higher SV, FFV, BFV, ASV, and MF in the calf region than did the non-PCS group. The variables that most strongly differentiated the patients with PCS from the HCs were SV in the great saphenous veins, SD in the great saphenous veins and left gonadal vein, and MV in the great saphenous veins and left gonadal vein. Caudal flow in the left gonadal vein was identified in half of the patients with PCS (39/81, 48.1%); 14 of them received embolization for left gonadal vein.
In additional to providing an objective 3-dimensional morphology of the pelvic veins and extrapelvic leaks, quantitative 2D PC-MRI analysis reveals distinct hemodynamic profiles between patients with PCS, those without PCS, and HCs, especially in the gonadal veins and regional perfusion of the calves.
探讨定量二维相位对比磁共振成像（2D PC-MRI）在盆腔淤血综合征（PCS）患者治疗中的应用。
作者采用2017年4月至2023年9月期间收集的定量2D PC-MRI数据进行回顾性横断面分析。此外，纳入了32名健康女性对照（HCs）。
大多数PCS患者表现为慢性盆腔疼痛，超过一半的患者有盆腔外静脉症状（分别为80/81，98%和45/81，56%）。定量2D PC-MRI分析了81例PCS患者、239例非PCS患者和32名HCs。PCS患者小腿区域（间质像素移位）的每搏输出量（SV）、绝对每搏输出量（ASV）和平均流量（MF）高于HCs。在左性腺静脉中，PCS患者的SV、逆流体积（BFV）、ASV和MF较高，而顺流体积（FFV）、行程距离（SD）和平均速度（MV）低于HCs。然而，PCS患者大隐静脉的SV、FFV、MF、SD和MV较低。定量2D PC-MRI分析显示，PCS组小腿区域的SV、FFV、BFV、ASV和MF高于非PCS组。最能区分PCS患者与HCs的变量是大隐静脉的SV、大隐静脉和左性腺静脉的SD，以及大隐静脉和左性腺静脉的MV。一半的PCS患者（39/81，48.1%）左性腺静脉出现尾向血流；其中14例接受了左性腺静脉栓塞术。
除了提供盆腔静脉和盆腔外渗漏的客观三维形态外，定量2D PC-MRI分析还揭示了PCS患者、非PCS患者和HCs之间不同的血流动力学特征，尤其是在性腺静脉和小腿区域灌注方面。
