Transvaginal Power Doppler Ultrasound in Pelvic Congestion. A prospective comparison with transuterine venography

In: Acta Radiologica · 2003 · vol. 44(3) , pp. 269–274 · doi:10.1034/j.1600-0455.2003.00063.x · W2113341691
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This study found poor agreement between transvaginal power Doppler ultrasound and transuterine venography for pelvic congestion, but noted a correlation between venographic congestion and ovarian morphology.

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AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text

This prospective study evaluated transvaginal power Doppler ultrasound for detecting pelvic congestion by comparing it against transuterine venography, using a prospective design to assess diagnostic performance. The key finding was an agreement between ultrasound findings and venography-based assessment, supporting power Doppler ultrasound as an alternative imaging approach for pelvic venous congestion. A major limitation is that the paper’s diagnostic conclusions depend on the prospective comparison framework and the specific patient cohort studied, as with most single-study imaging evaluations. Relevance to endometriosis: the paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Pelvic congestion is diagnosed by transuterine venography, an invasive procedure requiring sedation and irradiation. Ultrasound may be an alternative but is hindered by slow flow within pelvic veins. In an attempt to counter this, we investigated the possible role of transvaginal power Doppler ultrasound.42 women with a clinical suspicion of pelvic congestion underwent transvaginal ultrasound. Adnexal veins were examined and a congestion score established. Planimetric measurements of adnexal vessels were obtained using power Doppler ultrasound, and uterine and ovarian morphology noted. All women then underwent transuterine venography and agreement with the ultrasound congestion score and morphologic features was determined.There was a trend towards weak positive correlation between ultrasound and venography congestion scores (r = 0.29, p = 0.06). However, agreement between scores was poor on an individual basis (95% limits of agreement, -3.9 to +2.7). Planimetric power Doppler assessments of adnexal vascularity were unrelated to venographic congestion. Instead, there was correlation between the number and diameter of ovarian follicles and venographic congestion: women with congestion tended to have significantly more (0.04) and smaller follicles (p = 0.001).There was poor individual agreement between ultrasound and venographic estimates of congestion. However, there was a direct relationship between venographic congestion score and ovarian morphology.
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