Postpartum Ovarian Venous Thrombophlebitis: Clinical Manifestations and the Diagnostic Value of Non-Contrast Computed Tomography Semi-Quantitative Parameters

Background: Postpartum ovarian vein thrombophlebitis (POVT) is a rare yet potentially life-threatening complication. This study assesses the diagnostic utility of clinical manifestations and semi-quantitative parameters derived from non-contrast computed tomography (CT). Methods: A total of 34,140 postpartum patients at People’s Hospital of Yuxi City from December 2017 to October 2024 were included. Among them, only 24 POVT cases and 42 non-POVT puerperal women had complete clinical and CT datasets. In both groups, the CT attenuation values of the ovarian vein (OV) and inferior vena cava (IVC), OV diameter, CT attenuation difference (OV CT value minus IVC CT value), and OV/IVC attenuation ratio (OV CT value divided by IVC CT value) were recorded. Comparisons were made between the two groups regarding D-dimer levels, OV width, CT attenuation values, and OV/IVC attenuation ratio. Data were analyzed using SPSS version 27.0, the chi-square test, or the Mann-Whitney U test conducted at a significance level of <0.05. Results: D-dimer levels were significantly higher in the POVT group (7.66 ± 4.94 vs. 1.94 ± 0.91 μg/mL, p < 0.01). Semi-quantitative non-contrast CT metrics showed strong diagnostic performance: OV width ≥0.90 cm (sensitivity 91.70%, specificity 95.20%), thrombus CT value ≥46.00 HU (sensitivity 100%, specificity 100%), CT attenuation difference ≥12.50 HU (sensitivity 95.30%, specificity 100%), and OV/IVC attenuation ratio ≥1.10 (sensitivity 95.30%, specificity 100%) clearly distinguished POVT from non-POVT patients (p < 0.01). Conclusions: Non-contrast CT provides a valuable imaging modality for identifying POVT. D-dimer levels, combined with semi-quantitative CT parameters—OV width, thrombus CT value, CT attenuation difference, and OV/IVC attenuation ratio—can significantly improve diagnostic precision.