Prevalence of findings on sacroiliac MRİ in favor of pelvic congestion

Prevalence of findings on sacroiliac MRI in favor of pelvic congestion. Hacettepe University Faculty of Medicine, Thesis of Radiology, Ankara, 2019. Chronic pelvic pain (CPP) has significant impact on the quality of life of mostly premenopausal women. Prevalence of CPP is estimated to be 38 per 1.000 women (3.8%) which is higher than that of migraine headaches (2.1%). Pelvic congestion syndrome (PCS), which is thought to occur generally due to ovarian vein incompetence, is a recognized cause of chronic pelvic pain (CPP). Ovarian vein incompetence is seen in approximately 10% of women and up to 60% with this abnormality can develop PCS. Purpose: Sacroiliac MRI can show different clinical mimickers of sacroiliitis (SI) and PCS is one of these conditions. Our aim in this study was to evaluate the frequency of PCS and other incidental findings on sacroiliac MRI and to determine their relation to active or chronic sacroiliitis detected in MRI. Material-Methods: In our study, a total of 1361 sacroiliac MRI's of female patients aged between 15-55 years performed in the Department of Radiology of Hacettepe University Faculty of Medicine between January 2014–December 2017 (a 48-month period) were retrospectively evaluated. Patients included in the study were evaluated according to the Ankylosing SpondyloArthritis international Society's (ASAS) criterias for the presence of active and chronic sacroiliitis and findings in favor of PCS. The presence of dilated veins of ≥6 mm in diameter around the uterus and ovaries was accepted as a sign of PCS. Results: There were MRI detected sacroiliitis in 335 of the all patients (29%). 253 of the patients (21%) had active signs of sacroiliitis in MRI. 849 of the patients had no chronic or active signs of sacroiliitis in MRI. 6.7% (n = 80) of all patients, 5.5% (n = 14) (p = 0.464; p> 0.05) of patients with active sacroiliitis, 12% (n = 10) of patients with chronic sacroiliitis but without active sacroiliitis (n = 10) had MRI defined PCS findings. Conclusion: Sacroiliac MRI findings in favor of PCS was present in 6.7% of fertile aged women. Findings in favor of PCS in sacroiliac MRI are independent of the presence of active or chronic SI. Key words: Chronic pelvic pain, pelvic congestion syndrome, sacroilitis, spondyloarthritis, sacroiliac MRI