ct scanning is used to exclude abdominal or pelvic pathology. ct-angiography/venography can often demonstrate left ovarian vein reflux and image an enlarged left ovarian vein but is less sensitive and much more expensive than duplex doppler ultrasound examination. ultrasound requires that the ultrasonographer be experienced in venous vascular ultrasound and so is not always readily available. a second specialist ultrasound exam remains preferable to a ct scan.