ArticleEuropean journal of radiology open2026
The value of modified time-of-flight magnetic resonance venography in evaluating anatomical variations of the internal iliac vein.
Article in European journal of radiology open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To investigate the feasibility of using modified time-of-flight magnetic resonance venography (mTOF-MRV) to evaluate the anatomical variations of the internal iliac vein (IIV). Methods: This retrospective study included 158 patients suspected of iliac vein compression syndrome (IVCS) who underwent pelvic mTOF-MRV between June 2021 and March 2024. Fourteen patients with post-thrombotic syndrome (PTS) were excluded, leaving 144 eligible patients (52 males, 92 females; mean age 53 ± 16 years). Two radiologists independently evaluated image quality using a 4-point scale and analyzed IIV anatomical features via multiplanar reconstruction (MPR), maximum intensity projection (MIP), and volume rendering (VR) techniques. Inter-observer agreement was assessed using Cohen's kappa coefficient and intraclass correlation coefficient (ICC). Results: Inter-observer agreement for image quality was good (K=0.893), and for objective measurements was excellent (ICC [95 % confidence interval]: 0.893 [0.845-0.941]). Four IIV anatomical variation types were identified: Type I (unilateral single IIV draining to ipsilateral CIV bilaterally, 30.56 %), Type II (one/both pelvic cavities with two IIVs draining to ipsilateral CIV, 55.56 %), Type III (one IIV draining to ipsilateral CIV and the other to contralateral CIV, 11.80 %), and Type IV (other variations, 2.08 %). Left CIV compression was the most common (86.11 %). Conclusion: The mTOF-MRV clearly visualizes IIV anatomy and variations. The proposed classification system aids preoperative planning and postoperative hemodynamic evaluation for pelvic venous disorders.
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