Deciphering ovarian torsion: insights from CT imaging analysis

Area of Science:

• Radiology
• Emergency Medicine
• Gynecology

Background:

• Ovarian torsion is a common cause of pelvic pain in emergency medicine.
• Computed Tomography (CT) is frequently used for diagnosis in acute settings.
• Differentiating ovarian torsion from other causes of pain is challenging.

Purpose of the Study:

• To identify CT imaging features of surgically confirmed ovarian torsion.
• To evaluate CT's utility in differentiating ovarian torsion, including necrosis.

Main Methods:

• Retrospective analysis of 90 ovarian torsion patients (Jan 2015 - Apr 2019).
• Inclusion criteria: CT scan within one week of diagnosis.
• Systematic documentation of CT findings: ovarian size, pedicle/tube thickness, uterine deviation, etc.

Main Results:

• 53 patients had CT within one week; 41 used IV contrast.
• Common CT findings: thickened pedicle (81%), midline ovary (77%), thickened fallopian tube (63%), ipsilateral uterine deviation (62%).
• Mean ovarian diameter was 11.7 cm; sensitivity for torsion diagnosis was 47%.

Conclusions:

• Enlarged ovaries (>3.0 cm), thickened pedicle/tube, midline ovary, uterine deviation, and whirlpool sign are key CT indicators.
• Pelvic free fluid and intraovarian hematoma suggest necrosis and disease progression.
• CT findings aid radiologists in diagnosing ovarian torsion and assessing severity.