Learning objectives
The purpose of this educational review is to describe and illustrate the imaging features of ovarian torsion on ultrasound and computed tomography (CT) especially the key findings that can help the radiologistto make the diagnosis confidentely.
Background
Ovarian torsion is one of the serious gynecological emergency though infrequent. As clinical presentation is non-specific, makes it difficult to differentiate from other causes of acute abdominal pain like appendicitis, diverticulitis, renal colic.
Therefore imaging plays important role in making correct diagnosis which is important for fertility preservation. In addition, if the ovarian torsion is complete and is not diagnosed and untreated, hemorrhagic infarction can occur and may lead to peritonitis and death.
Common mimics of ovarian torsion are also the masses that predispose the...
Findings and procedure details
It is defined as a partial or complete rotation of the ovary and/or the ipsilateral fallopian tube and its respective pedicle around the ovarian suspensory ligament, resulting in arterial, venous, or lymphatic obstruction. Approximately 60% of cases of torsion occur on the right side.
Ultrasound findings include an enlarged ovary, ovarian mass, free fluid, follicles at the periphery of an enlarged ovary, thickening of a cyst wall, and a twisted pedicle. Absence of ovarianblood flow on Doppler sonography seems to be a good predictor of...
Conclusion
Ovarian torsion is one of the rare but fatal gynecological emergency that often presents with non-specific clinical features. Hence timely accurate diagnosis and prompt management is necessary to preserve ovarian viability and to avoid serious complications.
Therefore radiologist should be familiar with the common imaging findings of ovarian torsion like enlarged ovary with peripherally placed follicles and twisted ipsilateral vascular pedicle, although not often seen on imaging, but confirms the diagnosis when noted.
Personal information and conflict of interest
M. B. Jadhav; LSR,Durg/IN - nothing to disclose V. Lokhande; LSR,Durg/IN - nothing to disclose P. S. Jha; LSR,Durg/IN - nothing to disclose V. Gavhane; LSR,Durg/IN - nothing to disclose S. Jain; LSR,Durg/IN - nothing to disclose G. Verma; LSR,Durg/IN - nothing to disclose
References
1.Chang, Hannah C., Shweta Bhatt, and Vikram S. Dogra. “Pearls and pitfalls in diagnosis of ovarian torsion” Radiographics28, no. 5 (2008): 1355-1368
2.Shauna Duigenan,Esther Oliva, andSusanna I. Lee. "Ovarian Torsion: Diagnostic Features on CT and MRI With Pathologic Correlation” , American Journal of Roentgenology2012198:2,W122-W131