Added value of diffusion weighted MR imaging in the diagnosis of postpartum ovarian vein thrombosis

Abstract

Postpartum ovarian vein thrombosis (POVT) is a rare cause of right fossa pain but the diagnosis should be considered in the clinical setting of persistent fever and lower quadrant tenderness in the postpartum period. Although ultrasound is the initial step in the diagnostic work-up right fossa pain, it is often limited by overlying bowel gas and an enlarged puerperal uterus. Therefore, most authors recommend Computed Tomography (CT) as the imaging technique of choice to confirm the clinical suspicion of POVT. Because Magnetic Resonance Imaging (MRI) is less readily available, it is rarely performed for this indication. However, MRI allows not only to make the diagnosis as accurate as CT, but moreover it provides 2 important advantages in compared to CT. First, it avoids ionizing radiation. Secondly, the use of diffusion weighted imaging (DWI) may obviate the administration of intravenous contrast.