Ovarian torsion is serious cause of lower abdominal pain and is the gynecologic surgical emergency.
Ovarian torsion is an uncommon,
estimated as the cause of 2.7% of gynecologic emergencies in the United states.
An early and accurate diagnosis is important for fertility preservation.
if the ovarian torsion is complete and is not diagnosed and untreated,
hemorrhagic infarction can occur and may lead to peritonitis and death.
The clinical presentation is nonspecific and can mimic other diseases of acute abdominal pain.
Imaging therefore plays...
Methods and Materials
We retrospectively reviewed the CT and MRI imaging findings in 38 patients with surgically proved ovarian torsion between 2001 and 2012.
The age range of the patients was 11–68years (mean,
All patients complained of abdominal pain.
The interval between the onset of symptoms and CT or MRI imaging ranged from 1 day to 1 month (mean,
The interval between imaging and surgery ranged from 1 to 9 days (mean,
Unenhanced CT was performed in 22 patients and contrast enhanced...
The surgical procedure included ipsilateral salpingo-oophorectomy in 27 (71%),
removal of a benign ovarian tumor with preservation of the ovary in 9 (23%),
total abdominal hysterectomy and bilateral salpingooophorectomy in one (2%),
and only adnexal
detorsion in one (2%) of the patients.
All of ovarian torsion was unilateral,
with a slightly right-sided predominance (20:18).
The most common histologic diagnosis was mature cystic teratoma,
found in 21(55%) of the 38 patients.
Additional histologic diagnoses were benign cystadenoma in nine (23%),
simple cyst in one...
All patient of asymmetrical enhancement of ovarian veins were accompanied with fallopian tube thickening.
Since fallopian tube thickening are specific findings to ovarian torsion,
asymmetrical enhancement of ovarian veins may have little diagnostic value of torsion.
But all of the asymmetrical presence of contrast medium cases were hemorrhagic infarction.
Differentiation of hemorrhagic from nonhemorrhagic infarction is important for treatment planning.
This finding may suggest hemorrhagic infarction on CECT alone was performed,
even if abdomen is only scanned.
Our study had a number of limitations.
CT and MR imaging features of adnexal torsion.
CT features of adnexal torsion.
Ovarian torsion: CT and MR imaging appearance.
Radiology 1994; 190:337–341.
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Department of Radiology,Showa UniversityNorthern Yokohama Hospital,