Volume 48, Issue 3 September 2024 JVU 483-150 | Relationship Between Diameter and Pelvic Vein Reflux-Volume 48, Issue 3 September 2024 JVU 483-150 | Relationship Between Diameter and Pelvic Vein Reflux

Volume 48, Issue 3 September 2024 JVU 483-150 | Relationship Between Diameter and Pelvic Vein Reflux

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The referenced study, published in the Journal for Vascular Ultrasound, explores the relationship between pelvic vein diameter and venous reflux in women with suspected pelvic congestion syndrome (PCS). Ultrasonography, particularly transvaginal ultrasound (US), is a common diagnostic tool for evaluating venous valvular insufficiency in the lower extremities and pelvic regions.<br /><br />This study focuses on the correlation between pelvic vein diameter and the presence of reflux, a critical aspect in the management of PCS. Data from 104 women aged 25-76 were analyzed. Pelvic vein reflux was present in 52% of the patients examined. The study found that women with pelvic vein reflux had significantly larger vein diameters [8.4 ± 1.9 mm] compared to those without reflux [5.2 ± 1.0 mm]. Vein diameters ≥6.3 mm demonstrated high sensitivity (91%) and specificity (94%) for detecting reflux. Diameters greater than 6.3 mm indicated a high probability of reflux, whereas veins smaller than 5 mm typically did not exhibit reflux.<br /><br />The research highlighted the utility of extended noninvasive US examinations—incorporating transabdominal/pelvic and transvaginal US—over more traditional lower extremity vein evaluations. Ultrasonography revealed higher positive predictive values (PPV = 92%) and negative predictive values (NPV = 89%) for reflux detection in larger pelvic veins, suggesting that maximum vein diameter can indicate the presence of reflux, with larger veins correlating with greater likelihood of bilateral reflux.<br /><br />The findings underscore the importance of evaluating pelvic vein diameters when diagnosing and treating PCS. Larger veins are more likely to have reflux, and bilateral reflux is associated with substantially more dilation than unilateral reflux. Consequently, diameters of ≥6.3 mm are a strong indicator of pathological reflux, informing clinical decisions regarding patient management and potential endovascular treatments, such as coil or foam embolization.<br /><br />In conclusion, this study supports the diagnostic value of pelvic vein diameter measurements in predicting pelvic vein reflux, highlighting their role in improving the accuracy of PCS diagnosis and tailoring appropriate treatments.

Keywords

pelvic vein diameter

venous reflux

pelvic congestion syndrome

ultrasonography

transvaginal ultrasound

diagnostic tool

vein diameters

sensitivity

specificity

endovascular treatments