{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T01:13:14Z","timestamp":1791767594642,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,2,23]],"date-time":"2018-02-23T00:00:00Z","timestamp":1519344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>In the work\u2010up of patients with suspected pelvic congestion syndrome, venography is currently the gold standard. Yet if non\u2010invasive diagnostic tools are found to be accurate, invasive venography might no longer be indicated as necessary.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>A literature search in Pubmed and <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content> was performed from inception until 6 May 2017. Studies comparing non\u2010invasive diagnostic tools to a reference standard in the work\u2010up of patients with (suspected) pelvic congestion syndrome were included. Relevant data were extracted and methodological quality of individual included studies was assessed by the Quality Assessment of Diagnostic Accuracy Studies (<jats:styled-content style=\"fixed-case\">QUADAS<\/jats:styled-content>\u20102) tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine studies matched our inclusion criteria. Six studies compared ultrasonography to venography and three studies described a magnetic resonance imaging technique. In using transvaginal ultrasonography, the occurrence of a vein greater than five mm crossing the uterine body had a specificity of 91% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>; 77\u201398%) and occurrence of pelvic varicoceles a sensitivity and specificity of 100% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>; 89\u2013100%) and 83\u2013100% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>; 66\u201393%), respectively. In transabdominal ultrasonography, reversed caudal flow in the ovarian vein accounted for a sensitivity of 100% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>; 84\u2013100%). Detection of pelvic congestion syndrome with magnetic resonance imaging techniques resulted in a sensitivity varying from 88 to 100%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The sensitivity of ultrasonography and magnetic resonance imaging seem to be adequate, which indicates a role for both tests in an early stage of the diagnostic workup. However, due to methodological flaws and diversity in outcome parameters, more high standard research is necessary to establish a clear advice for clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13311","type":"journal-article","created":{"date-parts":[[2018,1,30]],"date-time":"2018-01-30T16:55:27Z","timestamp":1517331327000},"page":"776-786","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":75,"title":["Noninvasive diagnostic tools for pelvic congestion syndrome: a systematic review"],"prefix":"10.1111","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6097-1579","authenticated-orcid":false,"given":"Miranda P.","family":"Steenbeek","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Radboud University Medical Center Nijmegen the 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