Abstract
Purpose
To compare the imaging modalities of duplex ultrasound (DU) and magnetic resonance venography (MRV) in determining the presence of the anatomy associated with compression syndromes as well as the presence of pelvic varices in patients with suspected pelvic vein congestion syndrome (PCS).
Methods
A prospective study of 29 patients (27 females and 2 males) with signs and symptoms of PCS as well as MTS. Each patient underwent a DU and an MRV, for the purpose of diagnosing the presence of nutcracker anatomy (NA) and May–Thurner anatomy (MTA). The images were graded in an effort to determine if either DU or MRV was a better workup modality for the diagnosis of PCS and the compression syndromes that can be associated with it. A blinded independent reviewer did the grading.
Results
The left renal vein was well visualized to evaluate for the presence or absence of NA 89% of the time with DU and 81% of the time with MRV. The left common iliac vein was well visualized for the presence or absence of MTA 93% of the time with DU and 76% of the time with MRV. Pelvic varices were well visualized in 100% of the time for both DU and MRV.
With an experienced technologist performing the DU, our study has demonstrated that DU can consistently provide the needed imaging in a noninvasive and less-expensive manner while continuing to allow the clinician and patient to make a well-informed decision about their diagnosis and treatment.
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