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Nomogram prediction model based on non-enhanced computed tomography for adnexal torsion: A retrospective multicenter
Xiaowen Gu1, Lu Jiang2, Chijie Xu3
1Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou City, Jiangsu Province, China.
Summary
This study developed a nomogram using non-contrast computed tomography (CT) findings to predict adnexal torsion. Key CT signs like the navel sign and whirl sign accurately identify torsion risk in women with abdominal pain.
Area of Science:
- Radiology
- Gynecology
- Surgical Pathology
Background:
- Adnexal torsion is a gynecologic emergency often presenting with abdominal pain.
- Accurate preoperative diagnosis is crucial for timely intervention and fertility preservation.
- Non-contrast computed tomography (CT) can provide valuable diagnostic information.
Purpose of the Study:
- To develop and validate an individualized nomogram for predicting adnexal torsion.
- To identify independent risk factors for adnexal torsion from preoperative non-contrast CT findings.
- To assess the diagnostic performance of the nomogram.
Main Methods:
- Retrospective study of 200 women with surgically resected ovarian lesions and preoperative non-contrast CT.
- Patients divided into development (140) and validation (60) groups.
- Univariate and multivariate logistic regression analysis to identify risk factors; nomogram construction and validation using receiver operating characteristic curves (AUC) and calibration plots.
Main Results:
- Navel sign (OR 14.78), whirl sign (OR 38.05), and peri-adnexal fat haziness (OR 0.20) were significant predictors of adnexal torsion.
- The nomogram demonstrated good discrimination with AUC of 0.903 (development) and 0.861 (validation).
- Calibration plots indicated good agreement between predicted and actual probabilities.
Conclusions:
- The developed nomogram integrating navel sign, whirl sign, and peri-adnexal fat haziness is effective for predicting adnexal torsion.
- This tool is particularly useful when ultrasound or contrast-enhanced CT are unavailable.
- The nomogram aids in preoperative risk stratification for adnexal torsion.
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