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Right ovarian vein

The right ovarian vein is the major venous channel draining the ovary, adnexa, and parts of the uterine plexus on the right side. It originates in the ovarian venous plexus within the broad ligament, which communicates with the uterine venous plexus and pampiniform plexus of the ovary.

The vein ascends alongside the psoas muscle, lateral to the ureter and anterior to the lumbar vertebrae, before draining directly into the inferior vena cava (IVC) just below the level of the right renal vein. This contrasts with the left ovarian vein, which typically drains into the left renal vein.

The right ovarian vein contains valves, though incompetence can lead to pelvic congestion syndrome (PCS) or varices. The vein also plays a role in metastatic spread of pelvic tumors and can serve as a collateral pathway in cases of venous obstruction.

Synonyms

  • Right gonadal vein

  • Vena ovarica dextra

  • Right female gonadal vein

Function

  • Drains venous blood from the right ovary and adnexa

  • Connects with uterine venous plexus, contributing to uterine drainage

  • Acts as a collateral venous pathway in IVC obstruction

  • Clinically important in pelvic congestion syndrome and varicose ovarian veins

MRI Appearance

T1-weighted images:

  • Right ovarian vein appears as a linear flow void (dark lumen) along retroperitoneum lateral to IVC

  • Surrounded by intermediate signal retroperitoneal fat

T2-weighted images:

  • Normal vein: dark flow void

  • Dilated/varicose vein in PCS: hyperintense serpiginous structures around adnexa

STIR:

  • Suppresses fat, improving visibility of dilated ovarian veins against adnexal fat

  • Highlights perivascular edema in pelvic inflammation

T1 Fat-Saturated (Pre-contrast):

  • Lumen often intermediate signal, standing out against suppressed fat planes

  • More conspicuous in dilated or thrombosed states

T1 Fat-Saturated Post-Contrast (Gadolinium):

  • Enhances brightly and homogeneously in venous phase

  • Detects thrombosis, collateral venous channels, or reflux in PCS

MRV (Magnetic Resonance Venography):

  • Non-invasive mapping of the ovarian venous pathway

  • Clearly demonstrates the right ovarian vein draining into IVC

  • Useful for evaluating pelvic congestion, varices, and thrombosis

CT Appearance

CT Pre-Contrast:

  • Right ovarian vein appears as a tubular soft-tissue density ascending from adnexa to IVC

  • Can show hyperdense thrombus in acute ovarian vein thrombosis

CT Post-Contrast:

  • Vein enhances strongly in the venous phase

  • Useful for detecting thrombosis, compression, and varices

CTV (CT Venography):

  • Gold standard for detailed ovarian vein mapping

  • Shows vein’s origin in the pampiniform plexus and direct termination into IVC

  • 3D reconstructions demonstrate dilated venous channels, reflux, and collaterals

  • Critical for diagnosing pelvic congestion syndrome, ovarian vein thrombosis, and pre-embolization planning

MRI images

Right Ovarian Vein MRI coronal anatomy image -img-00000-00000

CT images

Right Ovarian Vein CT axial anatomy image -img-00000-00000

CT images

Right ovarian vein CT axial image