English

Abstract

BACKGROUND Ovarian torsion occurs when the ovary twists on its fibrovascular pedicle resulting in vascular compromise. Initially, there is twisting of the ovary, fallopian tube, or both structures, causing venous, lymphatic and arterial compromise with resultant ovarian oedema and adnexal enlargement. We wanted to determine the most common ultrasonography (USG) and magnetic resonance imaging (MRI) findings in surgically proven cases of ovarian torsion. METHODS We present a series of cases obtained on retrospective review of USG and MRI findings in 10 surgically proven cases of ovarian torsion between June 2018 to June 2020 in the Department of Radiology, MVJ Medical College & Research Hospital, Hoskote. RESULTS Significant enlargement of the ovary with size ranging from 5 to 15 cms with peripherally displaced follicles and free fluid in the pelvis in noted in all the patients on USG and MRI. Other common MRI features include ‘twisted vascular pedicle’ sign seen in 7 (70 %) cases, areas of haemorrhage within the ovarian stroma in 7 (70 %) cases and abnormal ovarian enhancement in 9 (90 %) cases. CONCLUSIONS Ultrasound and MRI are the main diagnostic imaging modalities prior to treatment. Improved detection and characterisation of pelvic mass contributes to better diagnostic accuracy. The most common findings in US and MRI features of ovarian torsion include ovarian enlargement with peripherally displaced follicles and free fluid in pelvis. Other common MRI features include ovarian haemorrhage, twisted vascular pedicle, abnormal ovarian enhancement and deviation of the uterus towards the same side. KEYWORDS Ovarian torsion, USG, MRI