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Reflux in the Left Ovarian Vein: Analysis of MDCT Findings in Asymptomatic Women

Tadao Hiromura1, Takeshi Nishioka2, Seiko Nishioka1, Hiroyuki Ikeda3 and Kazuo Tomita4

1 Department of Radiology, NTT East Corporation Sapporo Hospital, W-15, S-1, Chuo-Ku, Sapporo 0600061, Japan.
2 Department of Radiology, Hokkaido University School of Medicine, W-7, N-15, Kita-Ku, Sapporo 0608638, Japan.
3 Department of Surgery, NTT East Corporation Sapporo Hospital, Sapporo, 0600061, Japan.
4 Department of Internal Medicine, NTT East Corporation Sapporo Hospital, Sapporo 0600061, Japan.



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  		Fig. 1. —Drawing of anterior view of ovarian veins shows degrees of ovarian vein reflux. IVC = inferior vena cava, LK = left kidney, U = uterus, o = ovary.

 


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  		Fig. 2. —Drawing of left renal vein (LRV) in axial plane shows locations of diameter measurement. A is narrowest point that LRV passes between aorta (Ao) and superior mesenteric artery (SMA). B is site that left ovarian vein drains into LRV. LK = left kidney, LRV diameter ratio = B/A.

 


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  		Fig. 3A. —65-year-old multiparous woman with reflux in left ovarian vein. She has vascular variation of right ovarian vein draining into right renal vein. Transverse CT images obtained during renal corticomedullary phase of contrast enhancement show reflux in left ovarian vein (arrowhead, B and C) and parauterine varices. Left ovarian vein and parauterine veins (B and D) are dilated to 10.5 and 11.0 mm, respectively. Ratio of left renal vein (A) diameters (lateral–aortomesenteric portions) is 3.7. Note density of right ovarian vein (arrow, B and C) at different levels. Reflux does not occur in right ovarian vein.

 


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  		Fig. 3B. —65-year-old multiparous woman with reflux in left ovarian vein. She has vascular variation of right ovarian vein draining into right renal vein. Transverse CT images obtained during renal corticomedullary phase of contrast enhancement show reflux in left ovarian vein (arrowhead, B and C) and parauterine varices. Left ovarian vein and parauterine veins (B and D) are dilated to 10.5 and 11.0 mm, respectively. Ratio of left renal vein (A) diameters (lateral–aortomesenteric portions) is 3.7. Note density of right ovarian vein (arrow, B and C) at different levels. Reflux does not occur in right ovarian vein.

 


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  		Fig. 3C. —65-year-old multiparous woman with reflux in left ovarian vein. She has vascular variation of right ovarian vein draining into right renal vein. Transverse CT images obtained during renal corticomedullary phase of contrast enhancement show reflux in left ovarian vein (arrowhead, B and C) and parauterine varices. Left ovarian vein and parauterine veins (B and D) are dilated to 10.5 and 11.0 mm, respectively. Ratio of left renal vein (A) diameters (lateral–aortomesenteric portions) is 3.7. Note density of right ovarian vein (arrow, B and C) at different levels. Reflux does not occur in right ovarian vein.

 


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  		Fig. 3D. —65-year-old multiparous woman with reflux in left ovarian vein. She has vascular variation of right ovarian vein draining into right renal vein. Transverse CT images obtained during renal corticomedullary phase of contrast enhancement show reflux in left ovarian vein (arrowhead, B and C) and parauterine varices. Left ovarian vein and parauterine veins (B and D) are dilated to 10.5 and 11.0 mm, respectively. Ratio of left renal vein (A) diameters (lateral–aortomesenteric portions) is 3.7. Note density of right ovarian vein (arrow, B and C) at different levels. Reflux does not occur in right ovarian vein.

 


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  		Fig. 3E. —65-year-old multiparous woman with reflux in left ovarian vein. She has vascular variation of right ovarian vein draining into right renal vein. Oblique coronal maximum-intensity-projection image shows reflux in left ovarian vein passing to right ovarian vein (arrow).

 


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  		Fig. 4. —Graph shows ratios of left renal vein diameters between lateral and aortomesenteric portions in parous women with reflux versus those without reflux. Box plots indicate median and interquartile range (range, 25th–75th percentile), and vertical lines indicate total range (p = 0.0001).

 

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