Once other abnormalities or inflammation has been ruled out by a thorough pelvic exam, pelvic congestion syndrome can be diagnosed through several minimally invasive methods. An interventional radiologist will use the following imaging techniques to confirm pelvic varicose veins that could be causing chronic pain:
Thought to be the most accurate method for diagnosis, a venogram is performed by injecting contrast dye in the veins of the pelvic organs to make them visible during an X-ray. To help accuracy of diagnosis, interventional radiologists examine patients on an incline, because the veins decrease in size when a woman is lying flat.
Magnetic resonance imaging (MRI)
May be the best noninvasive way of diagnosing PCS. The exam needs to be done in a way that is specifically adapted for looking at the pelvic blood vessels. A standard MRI may not show the abnormality.
Usually not very helpful in diagnosing pelvic congestion syndrome (PCS) unless done is a very specific manner with the patient standing while the study is being done. Ultrasound may be used to exclude other problems that might be causing pelvic pain.
This technique is used to see better inside the pelvic cavity. As with pelvic ultrasound, it is not very good at visualizing the pelvic veins unless the woman is standing. However, it may be used to exclude other problems.
Reprinted with permission of the Society of Interventional Radiology © 2004, www.SIRweb.org. All rights reserved.