Sonographic Characteristics of Isolated Fallopian tube Torsion Compered to Ovarian and Adnexal Torsion. a Retrospective Trial

Abstract

Study Objective To characterize the sonograms of women diagnosed with either ovarian, fallopian tube or adnexal torsion and validate them with the actual laparoscopic surgery findings. Design A retrospective cohort study. Setting A single tertiary university affiliated gynecological ultrasound unit. Patients or Participants 204 women diagnosed at our gynecological ultrasound unit with either ovarian, fallopian tube or adnexal torsion during the years 2001-2019. Interventions Ultrasound reports of patients diagnosed with fallopian tube torsion were reviewed and compared to ovarian and adnexal torsion. Measurements and Main Results Ovarian volume was significantly higher in ovarian torsion (median 111cc,) compared to IFTT (median 29.2cc, p= 0.037). Ovarian texture was significantly more edematous in ovarian torsion compared to IFTT (p= 0.001). Whirlpool sign and its location was seen in all forms of torsion evenly. The ovarian blood flow was more compromised when the entire adnexa was involved rather than when only the ovary was (p=0.04). A trend showing less ovarian blood flow compromise was noted in IFTT (p=0.06). IFTT was associated with paraovarian cyst in significantly higher rate than other torsion forms (p=0.00). The odds for ovarian, adnexal, or fallopian tube torsion to occur without any pelvic mass and the mass size was not statistically different. Conclusion Sonographic findings can imply the presence of IFTT. In order to gain more sensitive and specific diagnosis, the physician should be familiar with the sonographic characteristics which are more prevalent in the different types of adnexal torsion as well as the characteristics which not differ between them. To characterize the sonograms of women diagnosed with either ovarian, fallopian tube or adnexal torsion and validate them with the actual laparoscopic surgery findings. A retrospective cohort study. A single tertiary university affiliated gynecological ultrasound unit. 204 women diagnosed at our gynecological ultrasound unit with either ovarian, fallopian tube or adnexal torsion during the years 2001-2019. Ultrasound reports of patients diagnosed with fallopian tube torsion were reviewed and compared to ovarian and adnexal torsion. Ovarian volume was significantly higher in ovarian torsion (median 111cc,) compared to IFTT (median 29.2cc, p= 0.037). Ovarian texture was significantly more edematous in ovarian torsion compared to IFTT (p= 0.001). Whirlpool sign and its location was seen in all forms of torsion evenly. The ovarian blood flow was more compromised when the entire adnexa was involved rather than when only the ovary was (p=0.04). A trend showing less ovarian blood flow compromise was noted in IFTT (p=0.06). IFTT was associated with paraovarian cyst in significantly higher rate than other torsion forms (p=0.00). The odds for ovarian, adnexal, or fallopian tube torsion to occur without any pelvic mass and the mass size was not statistically different. Sonographic findings can imply the presence of IFTT. In order to gain more sensitive and specific diagnosis, the physician should be familiar with the sonographic characteristics which are more prevalent in the different types of adnexal torsion as well as the characteristics which not differ between them.