Table 3.
Characteristics of included studies
| Author, year | Design | Index test | Parameters and thresholds | Reference test | Parameters and thresholds | Position of patient index test/reference test |
|---|---|---|---|---|---|---|
| Ultrasonography | ||||||
| Campbell, 200320 | Prospective cohort study | TVUS + power Doppler |
Ultrasound congestion score: ‐ diameter of the largest vein measured < 2 mm (1), 2–5 mm (2), > 5 mm 3 ‐ number of veins in the sector 0–2 (1), 3–6 (2), ≥ 7 (3) ‐ subjective assessment of congestion normal (1), moderate (2), severe (3) Total: 3 = normal, 9 = severe congestion |
Transuterine venography |
Venographic congestion score: ‐ ovarian vein diameter 1–4 mm (1), 5–8 mm (2), > 9 mm (3) ‐ contrast clearance < 20 s (1), 21–40 s (2), > 40 s (3) ‐ congestion absent (1), moderate (2), severe (3) Total: 3 = normal, 9 = severe congestion |
Supine/supine |
| Giacchetto, 199024 | Prospective cohort study | TVUS |
Pelvic varcies: Circular or linear anechogenic structures with a diameter > 5 mm found in transverse and oblique scan sections of the lateral fornices Vascular nature of these structures confirmed with Valsalva's maneuver and upright position |
Retrograde phlebography | Passive reflux in homolateral ovarian vein | Supine |
| Halligan, 200023 | Prospective case‐control study | TVUS + power Doppler |
Ultrasound congestion score: ‐ diameter of the largest vein measured < 2 mm (1), 2–5 mm (2), > 5 mm (3) ‐ number of veins in the sector 0–2 (1), 3–6 (2), ≥ 7 (3) ‐ subjective assessment of congestion normal (1), moderate (2), severe (3) |
Transuterine venography |
Venographic congestion score: ‐ ovarian vein diameter 1–4 mm (1), 5–8 mm (2), > 9 mm (3) ‐ Contrast clearance < 20 s (1), 21–40 s (2), > 40 s (3) ‐ Congestion absent (1), moderate (2), severe (3) PCS: ≥ 6 points |
Supine/supine |
| Park,200411 | Prospective case‐control study |
TVUS + TAUS + color Duplex |
Pelvic varicoceles: tortuous vein. Dilated ovarian vein: > 5 mm. Flow direction of ovarian vein |
Selective ovarian venography |
PCS: ‐ ovarian vein diameter > 5–10 mm ‐ or uterine vein engorgement ‐ or congestion of ovarian plexuses ‐ or filling of pelvic veins across the midline ‐ or filling of vulvovaginal and thigh varicosities |
Supine/unknown |
| Magnetic resonance imaging | ||||||
| Asciutto, 200812 | Prospective cohort study | MRV |
Pelvic venous insufficiency: ‐ dilatation ≥ 1.5 times the contralateral vessel ‐ or contrast depicting the pelvic plexus ‐ or varicose dilatation of hypogastric veins (tortuosity) |
Phlebography |
‐ Mild congestion; small, straight, similar in caliber and easily visualized ‐ Moderate congestion; vein variable in caliber, tortuous, difficult to see separately, diameter 0.5 –1.0 cm. ‐ Severe congestion; wide veins, great variation in caliber, markedly tortuous, diameter > 1.0 cm |
Supine/35° reverse Trendelenburg |
| Meneses, 201027 | Prospective cohort study | MR PCVM |
PCS: ‐ slow anterograde flow velocity (peak velocity < 5 cm/s ‐ or retrograde flow |
Direct venography |
PCS: ‐ ovarian vein diameter > 6 mm ‐ congestion of the ovarian plexus ‐ filling of the pelvic veins across the midline ‐ or filling of vulvovaginal and thigh varicosities |
Unknown/unknown |
| Yang, 201214 | Retrospective cohort study | TR‐MRA |
‐ Grade I: Reflux in the left ovarian vein or left parauterine veins ‐ Grade II: Grade I with reflux in the right ovarian vein, reflux in left or right internal iliac vein, or varicosities of vulva or thighs |
Selective ovarian venography |
‐ Grade I: Reflux in the left ovarian vein or left parauterine veins. ‐ Grade II: Grade I with reflux in the right ovarian vein, reflux in left or right internal iliac vein, or varicosities of vulva or thighs |
Supine/supine |
MR PCVM, magnetic resonance phase‐contrast velocity mapping; MRV, magnetic resonance venography; PCS, pelvic congestion syndrome; TAUS, transabdominal ultrasonography; TR‐MRA, time‐resolved magnetic resonance angiography; TVUS, transvaginal ultrasonography.