Can contrast enhanced ultrasound (CEUS) be useful in the diagnosis of ovarian torsion in pediatric females? A preliminary monocentric experience

Trinci, Margherita; Danti, Ginevra; Maurizio, Marco Di; Tursini, Stefano; Briganti, Vito; Galluzzo, Michele; Miele, Vittorio

doi:10.1007/s40477-021-00601-y

Cited by 10 publications

(8 citation statements)

References 31 publications

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“…The USG and CDUS signs in the setting of ovarian torsion are well established in literature; however, it is not always practically possible to reach a diagnosis preoperatively based on these signs, as was in our case 3. Out of the previously described USG signs, an enlarged right ovary with a large cyst and peripherally displaced ovarian follicles was seen in our case.…”

Section: Discussionmentioning

confidence: 50%

“…Besides, the spontaneous torsion and detorsion of ovary can produce variable patterns of Doppler flow which makes definitive diagnosis even more difficult. Even the established USG/CDUS signs suggestive of ovarian torsion do not always allow for a definitive diagnosis 3. Contrast-enhanced ultrasound (CEUS) is an excellent technique which overcomes these limitations.…”

Section: Introductionmentioning

confidence: 99%

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Ovarian torsion: incremental role of contrast-enhanced ultrasound

2022

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We highlight the role of contrast-enhanced ultrasound (CEUS) as a supplementary modality to ultrasound (USG) examination in ovarian torsion in this case report. The reported patient had clinical history suspicious of ovarian torsion; however, USG and Doppler flow study findings were equivocal. CEUS was performed to solve the diagnostic dilemma and to know the status of ovarian parenchymal viability which revealed non-enhancement of the ovarian cyst wall and pedicle throughout the USG examination thus establishing the diagnosis of non-viable or infarcted ovarian parenchyma. The per operative and histopathology findings were consistent with our CEUS findings. CEUS is an emerging promising modality which provides information regarding parenchymal perfusion, resulting in a reliable diagnosis of ovarian torsion along with information on ovarian parenchymal viability. This ability makes CEUS equivalent to contrast-enhanced CT or MRI.

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Section: Discussionmentioning

confidence: 50%

Section: Introductionmentioning

confidence: 99%

Ovarian torsion: incremental role of contrast-enhanced ultrasound

2022

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“…More recently, contrast-enhanced sonography has been explored as an improved diagnostic modality. 24 Machine-learning as well has been applied to develop sonographic algorithms in the identification of ovarian torsion, with a sensitivity of approximately 95% and specificity of 92%. 25 Cases with equivocal findings on imaging may require diagnostic laparoscopy.…”

Section: Diagnostic Imagingmentioning

confidence: 99%

Diagnosis and Management of Pediatric Ovarian Torsion in the Emergency Department: Current Insights

Scheier¹

2022

OAEM

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Ovarian torsion is defined as twisting of the ovary around an axis consisting of its vascular pedicle, the infundibulopelvic ligament and the tubo-ovarian ligament, and can occur in females of any age. Torsion can be a result of ovarian mass causing asymmetry and subsequent torsion, or can be spontaneous. While ovarian torsion is a surgical emergency, early diagnosis and treatment can preserve ovarian viability even if necrosis is seen operatively. Presentation classically involves sudden onset severe abdominal pain and vomiting but diagnostic delay can follow subtler presentations. Diagnosis is most commonly based on sonographic findings, but advanced imaging such as CT or MRI may be required if sonography is not diagnostic. Treatment is surgical, with ovarian preservation preferred in almost all cases. In this review, I present the most recent evidence on epidemiology, diagnosis, and management of pediatric ovarian torsion, with a focus on point-of-care ultrasound for the emergency care provider.

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“…Therefore, contrast-enhanced ultrasound technique seems perfectly suited to assess the vascularisation of the ovary and improve the diagnostic sensitivity of adnexal torsion. Its benefit has already been demonstrated in the diagnosis of testicular torsion in animals, but to date, only one study has evaluated its contribution in adnexal torsion 9 10…”

Section: Introductionmentioning

confidence: 99%

Contribution of contrast-enhanced ultrasound in the diagnosis of adnexal torsion (AGATA): protocol for a prospective comparative study

Pillot,

Hossu,

Cherifi

et al. 2023

BMJ Open

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IntroductionAdnexal torsion is a surgical emergency and its prognosis depends on the time elapsed prior to treatment. The diagnosis relies on pelvic ultrasound in which sensitivity remains low and may lead to misdiagnosis.The primary objective is to evaluate the diagnostic performance of contrast-enhanced ultrasound for the diagnosis of adnexal torsion in women with suspected adnexal torsion. The secondary objectives are: (1) to describe the perfusion parameters of the ovaries by contrast-enhanced ultrasound, (2) to compare diagnostic performance of contrast ultrasound with bidimensional (2D) Doppler for the detection of adnexal torsion, (3) to describe the perfusion parameters of the ovarian as a function of the degree of adnexal torsion, (4) to compare perfusion parameters before and after ovarian detorsion and (5) to describe perfusion parameters of the ovarian by using MicroVascular Flow technique.Methods and analysisThis is a monocentric, prospective comparative, non-randomised, open and interventional study. We hypothesise to include 30 women: 20 positive cases compared with 10 control cases. Women are informed and recruited in the emergency ward, over a period of 36 months.The primary endpoint is the signal intensity measurement to assess sensitivity, specificity, positive and negative predictive values of contrast-enhanced ultrasound for detection of adnexal torsion in women with suspected adnexal torsion. The presence or absence of adnexal torsion is confirmed during the surgical intervention.Ethics and disseminationThe study was approved by the French Ethics Committee, the CPP (Comité de Protection des Personnes) OUEST I on 3 July 2020 with reference number 2020T1-16. The results of this study will be published in a peer-reviewed journal and will be presented at relevant conferences.Trial registration numberClinicalTrials.gov registry (NCT04522219); EudraCT registry (2020-000993-27).

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Can contrast enhanced ultrasound (CEUS) be useful in the diagnosis of ovarian torsion in pediatric females? A preliminary monocentric experience

Cited by 10 publications

References 31 publications

Ovarian torsion: incremental role of contrast-enhanced ultrasound

Ovarian torsion: incremental role of contrast-enhanced ultrasound

Diagnosis and Management of Pediatric Ovarian Torsion in the Emergency Department: Current Insights

Contribution of contrast-enhanced ultrasound in the diagnosis of adnexal torsion (AGATA): protocol for a prospective comparative study

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