Ovarian veins: magnetic resonance imaging findings in an asymptomatic population

To evaluate the magnetic resonance (MR) venographic appearance of the ovarian veins in a healthy population, correlated with surgical findings. Our data can be used as a basis for comparison to patients with suspected pelvic congestion syndrome (PCS).

We retrospectively reviewed exams of 22 women who had MR angiography for potential renal donation evaluation (age range, 19.3-60.5 years; mean, 38 years). We evaluated the diameter of the ovarian veins on dynamic multiphasic postcontrast coronal images, the phase of contrast appearance in these veins, the apparent direction of flow, and the presence of ovarian or pelvic varices. Surgical correlation was obtained in 12 patients. Clinical charts were reviewed and patients were asked about symptoms of chronic pelvic pain and the number of their children.

Of the 22 exams, 21 left gonadal veins were identified. Passive reflux from the left renal vein into the left gonadal vein was suggested in eight exams (38%). These veins had a mean diameter of 6.4 +/- 1.6 mm, significantly larger than 4.5 +/- 1.3 mm for the other 13 left gonadal veins without reflux (P < 0.005). The right gonadal vein was identified in 8 of 22 women, with a mean diameter of 4.4 +/- 0.5 mm. No patient reported symptoms of chronic pelvic pain.

Passive reflux from the left renal vein to the left gonadal vein can occur in asymptomatic women. Diagnosis of PCS depends heavily on appropriate clinical history.