Adnexal torsion -- a multimodality imaging review

Adnexal torsion is a gynaecological surgical emergency as prompt restoration of ovarian blood flow may prevent permanent irreversible damage. Patients frequently present with non-specific symptoms and signs and therefore adnexal torsion is often an unexpected radiological diagnosis. Although ultrasound is the initial imaging technique of choice in suspected adnexal torsion, many patients undergo computed tomography (CT) or magnetic resonance imaging (MRI) either as a first-line test following non-specific presentation, or as a confirmatory test following equivocal ultrasound findings. Using multiple techniques, this review illustrates the wide variety of imaging features observed in adnexal torsion enabling a confident diagnosis that may result in a more favourable surgical outcome.