Using magnetic resonance phase-contrast velocity mapping for diagnosing pelvic congestion syndrome

Objective To evaluate phase-contrast velocity mapping (PCVM) as a diagnostic tool for pelvic congestion syndrome and comparing this approach with direct venography. Method We prospectively include nine women with clinical suspicion of pelvic congestion syndrome during a six-month period. All patients underwent a magnetic resonance phase-contrast scan before a direct venography. We considered a case of pelvic congestion syndrome when the PCVM showed a retrograde or slow (less than 5 cm/second) flow in any gonadal vein. This criterion was compared with the standard diagnostic criterion observed from a direct venography. Results Using direct venography we found 14 abnormal veins and all of them were correctly identified by the PCVM. The other four veins were found to be normal by the direct venography. However, two of them (the same patient) were abnormal in the PCVM, even though this patient had the classical symptoms of pelvic congestion syndrome. Conclusion PCVM is a useful tool for diagnosing pelvic contrast syndrome and can avoid invasive procedures such as direct venography.