VP04.05: Diagnostic accuracy of transvaginal ultrasound in adnexal torsion

Abstract

To assess the diagnostic accuracy of transvaginal ultrasound for the diagnosis of adnexal torsion and to describe ultrasound characteristics of adnexal torsion. This is a prospective study. 90 patients with clinical symptoms of adnexal torsion were evaluated by transvaginal ultrasound based on six suggestive signs (abnormal ovarian location, ovarian edema, whirlpool sign, abnormal ovarian blood flow, distended fallopian tube and fluid around the ovary). The findings were compared with surgical results. Among 90 patients with 103 ovarian tumours, 55 were operated and 34 were confirmed to have adnexal torsion (29 cases were correctly diagnosed and five cases were missed). The sensitivity, specificity, positive predictive value and negative predictive value of sonography for diagnosing adnexal torsion are: 85.3%, 84.1%, 72,5% and 92.1%, respectively. In addition, the sensitivity and specificity of the suggestive signs are: abnormal ovarian location: 29.4%, 95.5%; ovarian edema: 35.3%, 95.6%; whirlpool sign: 76.5%, 87%; abnormal ovarian blood flow: 41.2%, 98.5%; distended fallopian tube: 41.2%, 84.1%; fluid around the ovary: 91.2%, 36.2%. Transvaginal ultrasound is an excellent tool to evaluate patients with suspected adnexal torsion. Dermoid or unilocular tumour, loss of vascular signal and whirlpool sign are independent predictive factors of adnexal torsion.