Fig. 22

MRI of pelvic congestion syndrome in a 26-year-old woman with chronic pelvic pain and a recent severe exacerbation. Oblique-coronal T2-weighted image (a) shows ectatic vascular structures in the parametria, showing predominantly high signal intensity (arrowheads); in the left parametrium, some varices (arrow) display low signal intensity. Corresponding oblique-coronal gadolinium-enhanced fat-suppressed T1-weighted image (b) demonstrates vascular enhancement of the abovementioned structures (arrowheads), thus confirming pelvic varices