Adnexal torsion: color Doppler and three-dimensional ultrasound

To correlate preoperative ultrasound and color Doppler findings in patients with surgically proven adnexal torsion.

A 5-year retrospective study included 36 patients with acute lower abdominal and/or pelvic pain. Twenty-four patients had complete adnexal torsion followed by adnexectomy. Twelve patients with partially twisted adnexa underwent detorsion and were followed by 3-D power Doppler US 1 and 3 months thereafter.

2-D color Doppler US detected the absence of blood flow signals in the pedicles of 21 patients with complete adnexal torsion. Presence of the arterial blood flow signals within the pedicle alone was detected in three patients and was predictive of a non-viable ovary. The ovarian artery and vein were demonstrated in 10 patients with partial torsion. Venous signals alone were isolated in two patients with partial adnexal torsion. 3-D power Doppler indices of partially twisted adnexa following detorsion have improved significantly 1 (P < 0.05) and 3 months (P < 0.05), respectively, reaching normal intra-ovarian perfusion values.

2-D color Doppler and 3-D power Doppler US are useful in early diagnosis of complete adnexal torsion and follow-up of the ovarian reperfusion after detorsion of the partially twisted adnexa.