Adnexal Torsion: Review of Radiologic Appearances

Dawood, M.; Naik, Mitesh; Bharwani, Nishat; Sudderuddin, Siham A; Rockall, Andrea; Stewart, Victoria

doi:10.1148/rg.2021200118

Cited by 64 publications

(71 citation statements)

References 71 publications

(82 reference statements)

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“…The expected ovarian volume for a premenarchal child is 1-2 cm 3 . The next most common ultrasound finding is increased central echogenicity (40-85% of confirmed cases) thought to be secondary to stromal edema and/or hemorrhage [ 13 ]. Doppler studies are helpful in diagnosis when results show limited or no flow, but this should not guide clinical decision-making.…”

Section: Discussionmentioning

confidence: 99%

Ovarian Torsion: Presentation and Management in a Pediatric Patient

Nguyen

Valentino

Bui

et al. 2022

Case Reports in Obstetrics and Gynecology

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Background. Adnexal torsion is the fifth most common gynecologic emergency accounting for approximately 20 to 30% of ovarian surgeries in pediatric patients. Case. The patient is a ten-year-old female who presented to the emergency room for severe left lower quadrant abdominal pain. On presentation, she was hemodynamically stable with an acute abdomen. A transabdominal ultrasound showed a predominantly anechoic structure measuring up to 5.6 cm without definitive Doppler flow, concerning for a large cyst causing ovarian torsion. Gynecology was consulted, and the patient underwent a diagnostic laparoscopy, aspiration of the left ovarian cyst, and left ovarian detorsion. Pathology results were consistent with benign cystic contents. Conclusion. Appropriate diagnosis and timely surgical gynecological intervention allowed this pediatric patient to salvage and preserve ovarian function.

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Section: Discussionmentioning

confidence: 99%

Ovarian Torsion: Presentation and Management in a Pediatric Patient

Nguyen

Valentino

Bui

et al. 2022

Case Reports in Obstetrics and Gynecology

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“…Although this article’s focus remains limited to extra-ovarian pathologies, torsion is included because of its mechanism of twisting along the long axis of the fallopian tube and vascular pedicle. Adnexal torsion is twisting of the ovary, and often the fallopian tube, on its ligamental supports, causing vascular compromise [ 24 ]. It occurs most commonly in premenopausal patients who present with colicky lower abdominal pain radiating to the groin and adnexal tenderness on palpation.…”

Section: Intraperitoneal Lesionsmentioning

confidence: 99%

“…There may be variable blood flow on color Doppler, depending on the stage of torsion [ 27 ]. On CT and MRI, the ovary can become enlarged and medially displaced towards the center of the pelvis and twisted pedicle whirlpool or thickening of the pedicle can be discerned in 31–100% and 17–97% of the cases [ 24 ]. On MRI, the ovary appears enlarged and edematous with high-signal peripheralized follicles on T2WI ( Figure 7 ) and the fallopian tube appears twisted with wall thickening [ 24 , 28 ].…”

Section: Intraperitoneal Lesionsmentioning

confidence: 99%

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Mimics and Pitfalls of Primary Ovarian Malignancy Imaging

et al. 2022

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The complex anatomy and similarity of imaging features of various pathologies in the pelvis can make accurate radiology interpretation difficult. While prompt recognition of ovarian cancer remains essential, awareness of processes that mimic ovarian tumors can avoid potential misdiagnosis and unnecessary surgery. This article details the female pelvic anatomy and highlights relevant imaging features that mimic extra-ovarian tumors, to help the radiologists accurately build a differential diagnosis of a lesion occupying the adnexa.

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“…A premenarchal child's ovarian volume should be between one and two cm3. Increased central echogenicity, which occurs in 40-85 percent of confirmed cases and is assumed to be attributable to stromal edema and bleeding, is the second most frequent ultrasonography result [11]. Doppler examinations can assist in diagnosis when results show limited or no flow, but they should not be used to make clinical decisions.…”

Section: Case Presentationmentioning

confidence: 99%

Ovarian Salvation in Pediatric Ovarian Torsion: A Case Report

Brahmantara¹,

Hardjoto

Setiawan

et al. 2022

EJMED

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An accurate diagnosis of ovarian torsion is critical because of the possible long-term impact on fertility. Ovarian torsion is challenging to diagnose due to a generic clinical presentation and a wide range of imaging appearances. The pediatric group is even more challenging to serve since young people typically fail to define their symptoms or provide a thorough medical history. Imaging is, therefore, critical in diagnosing ovarian torsion in young people. A fourteen-year-old female went to the emergency room complaining of acute left lower quadrant stomach discomfort. She arrived hemodynamically stable with an acute abdomen. Transabdominal ultrasound revealed a primarily anechoic formation spanning 5x5 cm from the left adnexa, with the intact arterial flow but limited lymph node involvement. Transabdominal ultrasound revealed a primarily anechoic formation up to 5x5 cm in size from the left adnexa, with the maintained arterial flow but restricted venous outflow. The patient had an exploratory laparotomy, which revealed a left ovarian cyst (5.2 cm 5.4 cm 2.2 cm) with the left adnexa twisted 720°. The torsion was repaired with a simple cystectomy. Pathology results indicated that the cystic contents were benign. This juvenile patient's ovarian function was preserved thanks to an accurate diagnosis and prompt surgical surgery.

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Adnexal Torsion: Review of Radiologic Appearances

Abstract: Summarize the typical clinical manifestation of adnexal torsion.List the imaging features of adnexal torsion seen at US, CT, and MRI.Discuss important differential diagnoses based on imaging appearances to avoid potential misinterpretations.

Cited by 64 publications

References 71 publications

Ovarian Torsion: Presentation and Management in a Pediatric Patient

Ovarian Torsion: Presentation and Management in a Pediatric Patient

Mimics and Pitfalls of Primary Ovarian Malignancy Imaging

Ovarian Salvation in Pediatric Ovarian Torsion: A Case Report

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