DIAGNOSTIC IMAGING OF MAY TURNER SYNDROME
IN ACUTE DEEP VEINS THROMBOSIS
Fomina Е.Е.1,2, Yakhin А.М.1,2, Nemirovskaya Т.A.3,4, Akhmetzyanov R.V.4,5, Panasyk М.V.6
1 - Kazan State Medical Academy – Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical Academy of Continuing Professional Education». Kazan, Russia.
2 - Republican Clinical Hospital of Ministry Health of Tatarstan Republic. Kazan, Russia.
3 - Russian Medical Academy of Continuous Professional Education. Moscow, Russia.
4 - Interregional Clinical and Diagnostic Center. Kazan, Russia.
5 - Kazan State Medical University. Kazan, Russia.
6 - Kazan (Volga Region) Federal University. Kazan, Russia.
May Turner syndrome is considered to be secondary to compression of left common iliac vein between spinal column and right common iliac artery. Chronic compression may be associated with inflammation, fibrosis of venous wall intima, severe narrowing of the vessel orifice, venous hypertension and, consequently, may be complicated with local thrombotic masses formation. Diagnostic parameters of left common iliac vein compression in case of acute deep veins thrombosis had not been presented in the published literature.
Purpose. Examinationn of ultrasonic and CT parameters of pelvic veins in left-sided acute deep veins thrombosis considered as May Turner syndrome predictors.
Material and methods. Twenty patients, with mean age 37.4 ± 10.8, corresponded towards inclusion and non-inclusion criteria of the present study. First group included 16 patients presented with severe stenosis of the left common iliac vein, second group consisted 4 patients without stenosis and spreading of thrombotic masses into inferior vena cava. Ultrasonic examination (US) of pelvic veins was performed using Mindray Resona7 machine, computed tomography-assisted phlebography was performed on Phillips 64 Ingenuity scanner with automatic injector.
Results. High correlation of US parameters was revealed for pelvic veins diameters, (r = 0,7), gonadal veins diameters and volumetric blood flow values bilaterally (r = 0.9); significant CT phlebography parameters included left common iliac vein diameter before and after compression site (r = 0,7). According to the ultrasound examination results, the average values of the diameters of the left common iliac vein at the site of maximum compression were 0.27 ± 0.07 cm, with CT phlebography based values reaching – 0.28 ± 0.07 cm; at the level before compression – 0.90 ± 0.26 cm according to ultrasound and 68.03 ± 5.96 cm according CT phlebography. Left common iliac vein compression was absent in patients in the second group.
Discussion. Results of intergroup differences demonstrated that adherence to the diagnostic algorithm excludes identification of differences in the comparative results of the studied parameters during ultrasound and CT phlebography. Since venous compression persists in thrombosis, it can be suspected on ultrasound examination, and CT phlebography will confirm and determine the percentage of its narrowing. Left common iliac vein compressionn is considered as protection mechanism against central migration of thrombotic masses.
Conclusion. Ultrasound and CT parameters of the pelvic veins in acute deep vein thrombosis recognised in the present study allow us to diagnose signs of narrowing of the left common iliac vein, serving as predictors of May-Thurner syndrome coexistance.
Keywords: May Turner syndrome, left common iliac vein compression, CT phlebography, deep veins thrombosis, ultrasound examination of lower extremities veins.
Corresponding author: Fomina Е.Е., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Fomina Е.Е., Yakhin А.М., Nemirovskaya Т.A., Akhmetzyanov R.V., Panasyk М.V. Diagnostic imaging of May Turner syndrome in acute deep veins thrombosis. REJR 2026; 16(2):134-143. DOI: 10.21569/2222-7415-2026-16-2-134-143.
Received: 31.03.26 Accepted: 01.08.26