PMC3420710_01
Duplex ultrasound of suprapubic venous plexus. Note the tortuosity in the vessel and the continuous flow beneath the ultrasound probe.
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fig1
However, Doppler waveforms show continuous forward flow in the large subcutaneous venous plexus, Figure 1.
Axial MRI of pelvis with contrast showing large suprapubic varicosities (white arrows) and a small right external iliac (short arrows). The left external iliac vein is larger (long arrows).
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fig2
Magnetic venous imaging was obtained to evaluate pelvic and intra-abdominal varices and to better characterize the feeding and outflow vessels.  Figure 2 demonstrated large subcutaneous varicosities and a diminutive right external iliac vein compared to the left iliac vein.
MRI with contrast demonstrating abnormal iliac fossa varicosities (a) Conventional right femoral venogram demonstrating large right to left cross pelvic collaterals to the left femoral system (b).
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fig3
The reformatted MRI with Gadolinium, Figure 3(a), demonstrated the subcutaneous plexus and the collateral flow from right femoral system to the left femoral system via these enlarged cross-pelvic collaterals. The subsequent diagnostic conventional venogram is seen in Figure 3(b).