Acute torsion of the uterine adnexal structures (ovary and fallopian tube) is a recognized surgical emergency, but rarely has the diagnosis been made preoperatively on the basis of imaging studies. This report describes 16 cases in which the diagnosis was suggested preoperatively on the basis of sonography and subsequently confirmed at surgery. In all of the patients studied, a pelvic or pelvoabdominal mass was present on sonography. These masses had a sonographic texture ranging from cystic to solid, depending on the presence and extent of internal hemorrhage and/or stromal edema. In the majority of patients (13 of 16), adnexal torsion was associated with a preexisting cystic adnexal mass. Eight of these had thin internal septae. The severity of symptoms was variable and did not correlate directly with the sonographic features of the pelvic mass. Consideration of this entity in the proper clinical setting and with the typical sonographic findings will facilitate prospective recognition of adnexal torsion, thereby improving the chances for salvage of the involved adnexal structures.

Objectives We examined the association between regional brain uptake uptake of a novel amyloid PET tracer florbetapir F 18 ([18F]-AV-45) and cognitive performance in a pilot study. Design Cross-sectional comparison of florbetapir F 18 ([18F]-AV-45) in AD patients vs. controls. Setting 3 specialty memory clinics Participants 11 participants with probable Alzheimer’s disease (AD) by NINDS/ADRDA criteria and 15 healthy comparison participants (HC). Measurements Participants underwent PET imaging following a 370 MBq (10 mCi) i.v. administration of florbetapir F 18. Regional/cerebellar standardized uptake value ratios (SUVRs) were calculated. Cognition was assessed using Mini-Mental State Exam, Alzheimer’s Disease Assessment Scale-Cognitive subscale (ADAS-Cog), Wechsler Logical Memory IA (immediate recall) test (LMIA), and verbal category fluency. Results Greater florbetapir F 18 SUVR was associated with poorer performance on all cognitive tests. In the HC group, occipital, parietal, precuneus, temporal, and cortical average SUVR was associated with greater ADAS-Cog, and greater anterior cingulate SUVR was associated with lower LMIA. Two HCs had flobetapir F 18 cortical/cerebellar SUVR > 1.5, one of whom had deficits in episodic recall and on followup met criteria for amnestic MCI. Conclusions Florbetapir F 18 SUVR in several brain regions was associated with worse global cognitive performance particularly in HC, suggesting its potential as a marker of preclinical AD.

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