Reflux in the left ovarian vein: Analysis of MDCT findings in asymptomatic women

OBJECTIVE. The aim of this study was to clarify the CT features of ovarian vein reflux in asymptomatic women and to determine the possible cause of the reflux. MATERIALS AND METHODS. One hundred ten multiparous or uniparous and 41 nulliparous asymptomatic women were examined on MDCT. Degree, pathway, and associated findings of ovarian vein reflux were evaluated. We measured the diameters of the left renal vein (LRV), the ovarian veins, and the parauterine veins. Ratios of LRV diameters (lateral-aortomesenteric) were obtained. These data were then compared between the women with reflux and those without reflux. RESULTS. Reflux was found in 44% (48/110) of parous and 5% (2/41) of nulliparous women. Reflux flowed into the right ovarian vein through the parauterine and uterine veins in 25 women. Twenty-four of these 25 women were multiparous. In these cases, the parauterine veins showed varicose dilation (5.9 +/- 1.6 mm [mean +/- SD]). There was a statistically significant difference in left ovarian vein diameter (8.3 +/- 2.1 mm vs 4.9 +/- 1.3 mm, p < 0.0001) between parous women with reflux and those without reflux, respectively. The LRV diameter ratio (lateral-aortomesenteric) was also statistically significant (3.6 +/- 1.3 vs 1.7 +/- 0.7, p < 0.0001) between the same two groups. CONCLUSION. Reflux into the left ovarian vein is seen up into the contralateral ovarian plexus by passing through the dilated parauterine and uterine veins. This CT finding is common in asymptomatic multiparous women. Narrowing of the LRV at its aortomesenteric portion can be one of the causes of such reflux.