Accuracy of Pelvic Ultrasound in Diagnosing Adnexal Torsion

Labib Ghulmiyyah,Hadi Ramadan,Ghina Berjawi,Elie Najem,Anwar Nassar,Dib Sassine,Sally Khoury,Joseph Nassif

doi:10.1155/2019/1406291

Labib Ghulmiyyah, Hadi Ramadan + Show 6 more

Open Access

https://doi.org/10.1155/2019/1406291

Copy DOI

Abstract

Ovarian/adnexal torsion is a rather frequent occurrence in women of reproductive age group worldwide. Etiologies are quite diverse with ovarian lesions and corpus luteal cysts being the most two common. Pelvic or intravaginal ultrasound remains the first-line imaging modality used for diagnosis and evaluation of suspected ovarian/adnexal torsion. In this study, we have adopted a case-based statistical analysis to identify important sonographic markers and further evaluated their contribution in identifying ovarian torsion. Our study successfully determined the important sonographic markers. Our observation and analysis suggest that ovarian enlargement is the most sensitive marker. Ovarian edema was found to be the most specific marker to identify the ovarian torsion with higher level of accuracy and confidence. This pioneer study will provide valuable information and direction to the medical practitioners and radiologists for better diagnosis. Further studies with large sample size will help in establishing our findings universally.

Highlights

Adnexal torsion accounts for almost 3% of surgical emergencies [1]
Diagnosis of an ovarian torsion is challenging due to lack of sensitivity and specificity of its clinical signs [5]
Our study aims to identify the sonographic marker(s) that are most helpful in making an accurate diagnosis of adnexal torsion

Summary

Introduction

Adnexal torsion accounts for almost 3% of surgical emergencies [1]. It involves twisting of the ovary and/or fallopian tube leading to either a necrotic ovary or an undamaged ovary with impaired vascularization. This incidence is most common in women aged between 14 and 45 years. Diagnosis of an ovarian torsion is challenging due to lack of sensitivity and specificity of its clinical signs [5]. Patients with ovarian torsion show abdominal pain as the major clinical symptom [6, 7]. The diagnosis of ovarian torsion has been based on clinical findings

Methods

Results

Discussion

Conclusion