Ultrasonography in the diagnosis of pelvic vein insufficiency, a systematic review and meta-analysis.

Objective: To perform a systematic review and meta-analysis to investigate the efficacy of ultrasonography in the diagnosis of pelvic vein insufficiency (PVI).

Results: Seven studies comprised of 802 patients were included. Of these studies, 5 utilised transvaginal ultrasound (TVU), 1 utilised transabdominal ultrasound (TAU) and 1 utilised both ultrasounds as diagnostic tool .The overall pooled sensitivity and specificity was 0.96 and 0.84 respectively. The sensitivity and specificity for TVU were 0.96 and 0.86. The pooled sensitivities between studies employing a <7 mm cutoff in pelvic veins' diameter (PVD) and those employing a >7 mm threshold were 0.99 and 0.94 while the pooled specificities were 0.75 and 0.96 respectively.

Conclusion: The evidence supports the efficacy of ultrasonography in the diagnosis of PVI. A threshold of up to 6 mm in PVD yielded excellent sensitivity outcomes, but it is at the expense of specificity. This meta analysis suggests that a PVD threshold of 7 mm should be employed as a cutoff point in the diagnosis of PVI, displaying both excellent sensitivity and specificity outcomes.